ADC全容积直方图分析法鉴别乳腺良恶性肿块样病变

目的 探讨ADC全容积直方图分析法鉴别诊断乳腺良恶性肿块样病变的价值。方法 回顾性分析经手术及病理证实的88例乳腺肿块样病变患者，其中恶性57例、良性31例，均接受乳腺MR平扫+动态增强及DWI扫描，测量并记录ADC全容积直方图参数（包括多个百分位ADC值、ADC_min、ADC_max、ADC_mean、偏度、峰度及标准差）及常规平均ADC值。比较乳腺良恶性病变各ADC直方图参数及常规平均ADC值，采用ROC曲线分析评估各参数鉴别良恶性病变的效能。结果 良恶性病变ADC直方图参数（各ADC值、偏度、峰度、标准差）及常规平均ADC值差异均有统计学意义（P均<0.05）；其中第75、90百分位ADC值鉴别良恶性病变的AUC最高，为0.84。ADC直方图参数ADC_mean、第50百分位ADC值鉴别乳腺肿块样病变良恶性的AUC与常规平均ADC值的AUC比较差异均有统计学意义（P均<0.05）。结论 ADC全容积直方图可全面反映病灶整体信息，对鉴别乳腺良恶性病变具有一定价值。

ADC full volume histogram analysis in differentiating benign and malignant mass-like breast lesions

Objective To investigate the value of ADC full volume histogram analysis in differential diagnosis of benign and malignant mass-like breast lesions. Methods Totally 57 cases of malignant mass-like breast lesions and 31 cases of benign mass-like breast lesions confirmed by pathology were analyzed retrospectively. All patients underwent MR examination including plain scan, dynamic contrast enhanced MR and DWI. Conventional average ADC values and ADC full volume histogram parameters (including multiple percent ADC values, ADC_min, ADC_max, ADC_mean, skewness, kurtosis, and standard deviation) were measured and recorded. The conventional average ADC values and ADC histogram parameters were compared between benign and malignant lesions, and the ROC curves were used to evaluate the diagnostic efficacy of each parameter. Results There were significant differences in the ADC histogram parameters (ADC values, skewness, kurtosis, standard deviation) and conventional average ADC values between benign and malignant lesions (all P<0.05). The 75thADC and 90thADC values had the highest AUC in identifying benign and malignant lesions, which was 0.84. The AUC of the ADC_mean, 50thADC values in identifying benign and malignant lesions were statistically different from the AUC of the conventional average ADC values (both P<0.05). Conclusion ADC full volume histogram can fully reflect the overall information of lesions, and have certain value for identification of benign and malignant mass-like breast lesions.