摘要
目的探讨核磁弥散加权成像(DWI)及表面扩张系数值(ADC)在乳腺肿瘤良恶性鉴别诊断中的应用价值。方法选取60例乳腺病变患者,均行常规核磁共振扫描、动态增强扫描及DWI检查,经术后活检与病理学诊断确诊。在后处理工作站上完成对不同弥散敏感因子系数值(b值)500 s·mm^(-2)、1000 s·mm^(-2) DWI图像与ADC图像的信号强度、ADC值测量,采用ROC检验诊断效能,进行统计学分析。结果 b=500 s·mm^(-2)、1000 s·mm^(-2)时,良性病变平均ADC值均显著高于恶性病变,差异有统计学意义(P<0.05)。ADC图像上良性病变病灶呈相对高信号影,而恶性病变病灶呈相对低信号影,且与周围正常腺体组织分界清晰。b=500 s·mm^(-2)、1000 s·mm^(-2)时,ROC曲线下面积(AZ)=0.986、0.974,两b值对诊断乳腺良、恶性病变有统计学意义(P<0.05),两b值的AZ值比较差异无统计学意义(P>0.05)。根据ROC曲线确定良、恶性病变ADC诊断阈值,b=500 s·mm^(-2)、1000 s·mm^(-2)时,阈值分别为1.21×10^(-3)s·mm^(-2),1.12×10^(-3) s·mm^(-2),据此阈值分析出恶性病变诊断的敏感度为91.67%、95.83%,特异度为97.22%、91.67%。结论 DWI及ADC值测量在良、恶性乳腺肿瘤中具有较高的诊断和鉴别价值,可提高恶性病变诊断的敏感度、特异度。
Objective To evaluate the application value of magnetic diffusion weighted imaging （DWI） and apparent diffusion coefficient （ADC） value in the differential diagnosis of benign and malignant breast tumors. Methods A total of 60 patients with breast lesions treated in our hospital between March 2015 and February 2017 were examined with routine scan, dynamic enhanced scan and DWI, and they were confirmed by postoperative biopsy and pathology. In the postprocessing workstation, the different diffusion sensitive factor coefficient value （b） 500 s·mm^-2 and 1000 s·mm^-2 DWI images, signal intensity of ADC images and ADC values were measured. The diagnostic efficiency was test by ROC, and statistical analysis was performed. Results When b=500 s·mm^-2 and 1000 s·mm^-2, the average ADC value of benign lesions was significantly higher than that of malignant lesions （P〈0.05）. Benign lesions showed relatively high signal on ADC images while malignant lesions showed relatively low signal, and the boundaries with the surrounding normal glandular tissues were clear. When b=500 s·mm^-2 and 1000 s·mm^-2, the area under ROC （AZ）=0.986, 0.974, there were significant differences between the two b values in the diagno- sis of benign and malignant breast lesions （P 〈 0.05）, but there was no significant difference in AZ value between the two b values （P 〉 0.05）. According to the ROC, the thresholds of ADC in the differential diagnosis of benign and malignant lesions were determined, as b=500 s·mm^-2 and 1000 s·mm^-2, the thresholds were 1.21 ×10^-3 s·mm^-2 and 1.12 ×10^-3 s·mm^-2, respectively. According to such threshold, the sensitiv- ity and specificity in the diagnosis of malignant lesions were 91.67% and 95.83%, 97.22% and 91.67%, respectively. Conclusion DWI and ADC are of high value in the differential diagnosis of benign and malignant breast tumors. They can improve the sensitivity and specificity in the diagnosis of malignant lesions.
出处
《肿瘤药学》
CAS
2017年第4期499-503,共5页
Anti-Tumor Pharmacy
基金
常德市科技计划一般项目(2013SK09)
关键词
DWI
ADC
乳腺肿瘤
良恶性
诊断
DWI
ADC
Breast neoplasms
Benign and malignant
Diagnosis
