分段读出扩散加权成像序列ADC值在乳腺良恶性肿瘤鉴别诊断中的价值

Value of ADC of readout segmentation of long variable echo-trains in differential diagnosis of breast benign and malignant tumors

目的探讨分段读出扩散加权成像(RESOLVE)序列ADC值鉴别乳腺良恶性肿瘤的价值。方法收集经手术病理证实的乳腺肿瘤患者49例,其中良性肿瘤20例,恶性肿瘤29例,术前均行常规MRI及RESOLVE序列DWI扫描(b=0、800s/mm2),选取感兴趣区测量肿瘤的ADC值,采用独立样本t检验比较乳腺良性肿瘤组和恶性肿瘤组ADC值的差异,以病理结果为金标准,绘制ADC值的ROC曲线,分析ADC值对乳腺良、恶性肿瘤的诊断效能。结果乳腺良性肿瘤组ADC平均值为(1.368±0.371)×10-3mm2/s,恶性肿瘤组ADC平均值为(0.815±0.253)×10-3mm2/s,两组间比较差异有统计学意义(P<0.001)。ROC曲线显示,ADC值区分乳腺良恶性肿瘤的最佳诊断界值为1.013×10-3mm2/s,敏感性为92.81%,特异性为88.52%。结论 RESOLVE序列ADC值在乳腺良恶性肿瘤鉴别诊断中具有一定的应用价值。

Objective To explore the value of ADC of readout segmentation of long variable echo-trains (RESOLVE) in differential diagnosis of benign and malignant breast tumors. Methods Selected 49 breast tumors patients confirmed by opera-tion, 20 cases had breast benign tumors, 29 cases had breast malignant tumors. They all accepted MRI cxamination and RE-SOLVE(b=0 and 800s/mm2). Interested region(ROI) of breast tumor was drawn to record the ADC value. The difference of ADC value between benign and malignant breast tumors was compared by independent samples t-test. Receiver operating characteris-tic curve (ROC) was used to determine the best diagnostic cut-off point. Results The average value of ADC in breastbenign tu-mors was(1.368±0.371)×10-3mm2/s. The average value ofADC in malignant breast tumors was(0.815±0.253)×10-3mm2/s. The difference of ADC between benign and malignant breast tumors was statistically significant(P<0.001). Receiver operating characteristic curve showed that the best diagnostic cut -off point was 1.013 ×10 -3mm2/s, diagnostic sensitivity was 92.81% and specificity was 88.52%. Conclusion RESOLVE ADC value is valuable in the differential diagnosis of benign and malignant breast tumors.