摘要
目的评价ADC值定量对腋窝淋巴结的定性诊断价值并探讨b值的优化选择。材料与方法搜集在我院进行乳腺磁共振扩散加权成像(DWI)及动态增强扫描患者,DWI扫描选取3组b值(0、400 s/mm2,0、800 s/mm2,0、1000 s/mm2)分别进行扫描;对有明确手术病理结果和(或)针吸活检病理结果的59例患者共96枚腋窝淋巴结进行回顾性分析。结果 3组b值下恶性淋巴结的ADC值明显低于良性淋巴结,有显著统计学差异(P=0.000),b=400 s/mm2时,以1.24×10-3mm2/s为阈值,诊断良恶性病变的敏感性、特异性分别是88.53%、62.85%;b=800 s/mm2时,以0.955×10-3mm2/s为阈值,分别为77.14%、78.69%;b=1000 s/mm2时,以0.890×10-3mm2/s为阈值,分别是77.14%、81.97%。3组b值ROC曲线下面积分别为0.828,0.849,0.873。结论 ADC值对腋窝良恶性淋巴结具有较高的鉴别诊断价值。当b=1000 s/mm2时,ADC值定量诊断效能最高。
Objective： To compare apparent diffusion coefficient measurement of benign axillary lymph node and malignant axillary lymph node identification value and optimizing b value. Materials and Methods：By collecting in the hospital for breast dynamic contrast-enhanced scans and diffusion-weighted imaging,using three b values （400, 800, 1000 s/mm2）. 59 patients （96 lymph nodes） with a clear outcome of the surgery and pathology and/or needle biopsy results were retrospectively analyzed. Results：The ADC values of malignant lesions were signifi cantly lower than those of benign lesions（P=0.00）.The sensitivity and specificity were 88.53%and 62.85%, 77.14% and 78.69%, 77.14% and 81.97% respectively when b=400, 800 and 1000 by using a threshold ADC of less than 1.240, 0.955, 0.890×10-3mm2/s respectively. Areas under the curve are 0.828, 0.849, 0.873 as b=400 s/mm2, 800 s/mm2, 1000 s/mm2, respectively. Conclusions：The ADC value has moderate diagnosis potency in differentiating benign and malignant lymph node. The optimal b value is 1000 s/mm2.
出处
《磁共振成像》
CAS
CSCD
2014年第4期264-268,共5页
Chinese Journal of Magnetic Resonance Imaging
关键词
乳腺肿瘤
窝淋巴结
磁共振成像
弥散
Breast neoplasms
Axillary lymph node
Diffusion magnetic resonance imaging
