Role of diffusion-weighted MR imaging in assessing malignant versus benign skull-base lesions

Purpose

This study was done to assess the role of diffusion-weighted magnetic resonance (MR) imaging in assessing malignant versus benign skull lesions.

Materials and methods

A retrospective analysis was undertaken of 45 patients (26 male, 19 female; age range 14?C68 years, mean age 39 years) with skull-base lesions. Diffusion-weighted MR images were acquired with a bfactor of 500 and 1,000 s/mm² using single-shot echoplanar imaging. Apparent diffusion coefficient (ADC) maps were reconstructed, and the ADC value of the lesion was calculated.

Results

The mean ADC value of malignant tumours was (1.002±0.21)×10^?3 mm²/s and that of benign tumours was (1.63±0.29)×10^?3 mm²/s. There was a statistically significant difference (p=0.001) in the ADC value of malignant skull-base tumours versus benign lesions. Selection of (1.3)×10^?3mm²/s as a threshold value of ADC for differentiating benign from malignant tumours yielded the best result, with an accuracy of 94%, sensitivity of 94%, specificity of 93%, positive predictive value of 93%, negative predictive value of 94% and area under the curve of 0.932.

Conclusions

We conclude that diffusion-weighted MR imaging is a promising, noninvasive approach that can be used to characterise skull-base lesions in that it can help differentiate malignant tumours from benign lesions and evaluate the pathological grading of malignant tumours.     

DWI在鉴别诊断膀胱良恶性病变中的应用价值

目的：探讨磁共振（magnetic resonance ,MR）弥散加权成像（diffusion-weighted imaging ,DWI）中的表观扩散系数（apparent diffusion coefficient ,ADC）及相对表观扩散系数（r-ADC）值在膀胱良恶性病变鉴别诊断中的应用价值。方法共收集2012年10月～2013年5月75例超声诊断为膀胱占位患者,并最终经膀胱镜病理确诊。所有患者均行常规横断位T1 WI、T2 WI、DWI（b值为0和1500s/mm2）,横断位和冠状位增强LAVA序列。测量病灶及病灶对侧膀胱壁的ADC值及r-ADC值进行统计学分析。结果所有恶性膀胱肿瘤病灶及4例良性病灶在DWI图像上病灶显示为明显高信号。恶性膀胱肿瘤病灶平均ADC值（0．85±0．30）×10-3 mm2/s明显低于良性病灶的 ADC值（1．62±0．86）×10-3 mm2/s）（ P ＜0．05）。恶性肿瘤性病灶的r-ADC值（0．74±0．27）也明显低于良性肿瘤性病灶（1．20±0．73）（ P ＜0．01）。结论结论DWI在鉴别膀胱良恶性肿瘤中有较高的应用价值,是一种较可靠的检查方法。     

DWI与DCE-MRI联合应用对乳腺良恶性病变鉴别诊断价值的Meta分析

目的 运用Meta分析方法研究近几年在最新技术条件下扩散加权成像(DWI)与动态对比增强磁共振成像(DCE-MRI)联合应用对乳腺良恶性病变的鉴别诊断价值.方法 检索PubMed、EMbase、Web of Science、Cochrane图书馆、中国期刊网(CNKI)的英文和中文文献,按照Cochrane协作网推荐的诊断试验纳入标准筛选文献,提取纳入研究的特征信息.文献评价采用诊断研究评价工具QUADAS-2.数据分析采用Meta-DiSc1.4软件,检验异质性,并根据异质性结果选择相应的效应模型.对所有研究进行加权定量合并,计算汇总灵敏度(Se)、汇总特异度(Sp).绘制汇总受试者工作特征曲线(SROC),并计算曲线下面积(AUC).结果 纳入28项研究,共1 707例患者、1 857个病灶.28项研究存在异质性,按照随机效应模型计算汇总Se、汇总Sp分别为93％、88％,SROC的AUC为0.96.结论 DWI与DCE-MRI联合应用对乳腺良恶性病变的鉴别诊断具有很高的灵敏度和特异度,是一种诊断效能较高的检查方法.     

MR扩散加权成像对乳腺病变良恶性鉴别的Meta分析报告

目的 采用Meta分析方法综合定量评价MR扩散加权成像(DWI)对乳腺良恶性病变的鉴别诊断价值.方法 检索Cochrane图书馆、Pubmed、Ovid循证医学数据库、Elsevier和Springer数据库及中国期刊网1997至2007年公开发表的中英文文献,按照Cochrane协作网推荐的诊断试验纳入标准筛选文献,提取纳入研究的特征信息.采用Q检验和Meta分析对纳入文献行统计学处理.结果 共纳入文献6篇,研究病灶共计479个.DWI诊断乳腺病变良恶性的敏感度范围为64.0%.92.8%,特异度范围为45.8%～96.7%.纳入文献具同质性,按照固定效应模型计算出的汇总加权敏感度和特异度及95%可信区间分别为86%(76%～92%)和80%(61%～91%);汇总受试者工作特征曲线(SROC)下面积为92.19%.敏感度分析显示纳入文献稳定性好.结论 DWI的表观扩散系数(ADC)值测量有助于乳腺病变的良恶性鉴别,但缺乏统一的扩散敏感因子(b)值和诊断阈值,其临床应用价值仍有待于前瞻性研究进一步证实.     

Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging

PURPOSE: To evaluate the value of diffusion-weighted imaging (DWI) in distinguishing between benign and malignant breast lesions. MATERIALS AND METHODS: Fifty-two female subjects (mean age = 58 years, age range = 25-75 years) with histopathologically proven breast lesions underwent DWI of the breasts with a single-shot echo-planar imaging (EPI) sequence using large b values. The computed mean apparent diffusion coefficients (ADCs) of the breast lesions and cell density were then correlated. RESULTS: The ADCs varied substantially between benign breast lesions ((1.57 +/- 0.23) x 10(-3) mm(2)/second) and malignant breast lesions ((0.97 +/- 0.20) x 10(-3) mm(2)/second). In addition, the mean ADCs of the breast lesions correlated well with tumor cellularity (P < 0.01, r = -0.542). CONCLUSION: The ADC would be an effective parameter in distinguishing between malignant and benign breast lesions. Further, tumor cellularity has a significant influence on the ADCs obtained in both benign and malignant breast tumors.     

1.5T DWI在肺内良、恶性病变鉴别诊断中最适b值的探讨

目的:探讨1.5TDWI对肺内良、恶性病变的鉴别诊断价值及b值的优化。方法:搜集40例经病理/临床证实的肺内良、恶性病变患者(恶性病变23例,良性病变17例)的影像及临床资料,40例均经MSCT检查发现肺部病变,并行常规T1WI、T2WI以及多b值DWI(b=0,300,600,1000s/mm2)检查,测量3组b值测得的ADC值,分析不同b值对图像质量、信噪比(SNR)、对比噪声比(CNR)的影响,根据受试者工作特征(ROC)曲线评价不同b值下ADC值鉴别肺部良、恶性病变的诊断效能;并比较同一b值下良、恶性病变ADC值的差异。结果:随着b值的增加,DWI图像信号逐渐增高,ADC、SNR及CNR值逐渐下降;b值为300和600s/mm2两组图像SNR值差异无统计学意义(P>0.05),b值为300与1000s/mm2以及600与1000s/mm2两组SNR值差异均具有统计学意义(P均<0.05);CNR值在两两组间的差异均具有统计学意义(P均<0.05)。b值为300、600和1000s/mm2时,ROC的曲线下面积(AUC)分别为0.78、0.83和0.81,且均具有诊断意义(AUC均>0.5),当b=600s/mm2时,诊断效能最高。在同一b值下,恶性病变图像信号高于良性病变,且ADC值低于良性病变(P均<0.05)。结论:1.5T DWI多b值胸部扫描有助于鉴别肺内良、恶性病变,当b=600s/mm2时,对肺良、恶性病变的鉴别诊断效能最高。     

双时相18F-FDG PET显像用于肿瘤良恶性鉴别诊断

目的探讨双时相^18F-FDG PET显像在肿瘤良恶性鉴别中的临床价值。方法52例单次显像难以鉴别病变性质的患者行双时相全身^18 F-FDG PET／CT显像，将显像结果与病理学检查结果对照。结果43例延迟显像SUV升高的患者中有39例经病理检查证实为恶性病变，4例为良性病变；9例延迟显像SUV降低的患者中有7例经病理检查证实为良性病变，2例为恶性病变。灵敏度为95．1％，准确性为88．5％，特异性为63．6％，阳性预测值为90．7％，阴性预测值为7／9例。结论双时相^18F—FDG PET对良恶性病变的鉴别具有较高的灵敏度和准确性。     

MR扩散加权成像鉴别颅内囊性病变的价值

目的探讨MR扩散加权成像（DWI）在颅内囊性病变中的鉴别诊断价值。方法对76例经临床及手术病理证实的颅内囊性病变患者，行常规MR、DWI及增强MR检查，其中脑脓肿19例，原发性脑胶质瘤20例，小脑血管母细胞瘤4例，脑转移瘤10例，蛛网膜囊肿7例，表皮样囊肿16例。回顾性分析颅内囊性病变的DWI信号特征，定量测定囊性变区表观扩散系数（ADC）值。结果DWI上19例脑脓肿呈高信号；34例脑肿瘤患者中，除3例脑胶质瘤呈高信号、1例呈等信号，1例脑转移瘤呈高信号外，其余29例均呈低信号。各种病变ADC值分别为：脑脓肿（0．62±0．15）×10^-3 mm^2／s、脑胶质瘤（2．39±0．78）×10^-3 mm^2／s、脑血管母细胞瘤（2．68±0．40）×10^-3 mm^2／s、脑转移瘤（2．79±0．79）×10^-3 mm^2／s。脑脓肿与脑胶质瘤、脑血管母细胞瘤、脑转移瘤的囊变坏死区ADC值比较，差异均有统计学意义（P〈0．01）；脑胶质瘤与脑血管母细胞瘤、脑转移瘤的囊变坏死区ADC值比较，差异均无统计学意义（P〉0．05）。7例颅内蛛网膜囊肿的DWI呈低信号；16例表皮样囊肿DWI呈明显高信号。颅内蛛网膜囊肿和表皮样囊肿的ADC值分别为（2．96±0．36）×10^-3 mm^2／s和（0．94±0．13）×10^-3 mm^2／s，二者之间差异有统计学意义（P〈0．01）。结论DWI及ADC值对鉴别脑脓肿和囊性或坏死性脑肿瘤具有重要的价值，DWI表现为低信号的颅内囊性病变可除外脑脓肿。     

Diagnostic accuracy of diffusion-weighted imaging in differentiating benign from malignant ovarian lesions

Purpose

To clarify the diagnostic accuracy of diffusion‐weighted imaging (DWI) in differentiating benign from malignant ovarian lesions.

Materials and Methods

We retrospectively analyzed magnetic resonance images of 123 ovarian lesions in 119 patients. We defined lesions with abnormal signal intensity as malignancy and assessed the location of abnormal intensity within the lesions on DWI. We also assessed the mean and lowest apparent diffusion coefficient (ADC) values of the solid portion for each ovarian lesion.

Results

The majority of malignant ovarian tumors and mature cystic teratomas, and almost half of the endometriomas, showed abnormal signal intensity on DWI, whereas most fibromas and other benign lesions did not. The main locations of abnormal signal intensity were solid portions in malignant ovarian tumors, cystic components suggestive of keratinoid substances and Rokitansky protuberance in mature cystic teratomas, and intracystic clots in endometriomas. On DW imaging, receiver‐operating characteristic analysis yielded mean Az values of 0.703. There was no significant difference in mean and lowest ADC values between malignant and benign lesions.

Conclusion

DWI of ovarian lesions and ADC values of the solid component are not useful for differentiating benign from malignant ovarian lesions. This knowledge is essential in avoiding misinterpretation in the diagnosis of ovarian lesions. J. Magn. Reson. Imaging 2008;28:1149–1156. © 2008 Wiley‐Liss, Inc.     

Role of diffusion-weighted MR in differential diagnosis of intracranial cystic lesions

AIM: The purpose of this study was to evaluate the role of diffusion-weighted imaging (DWI) in characterizing cerebral cystic lesions. The usefulness of the apparent diffusion coefficient (ADC) map in lesion characterization was also evaluated. METHODS: We compared the findings of conventional MR images with those of DWI: 63 cystic masses in 48 patients were examined with routine MR imaging and echo-planar DWI. The routine MR imaging included at least the axial T2- and T1-weighted sequences, and post-contrast T1 axial sequences. The DWI included an echo-planar spin-echo sequence with three values (0, 500 and 1000s/mm(2)) sensitizing gradient in the x, y, z direction, and it obtained an ADC map. RESULTS: The sensitivity of DWI for differentiating abscesses from primary brain tumours was 100%; for differentiating abscesses from metastatic tumours was 73%; for differentiating benign from malignant lesions was 90%. CONCLUSION: Although some metastatic lesions may appear hyperintense on DWI thus imitating an abscess, evaluation of the lesions with both DWI and conventional MRI may have an important contribution to the differentiation of tumours from abscesses.     

磁共振扩散加权成像在乳腺良恶性病变中的诊断价值

目的探讨磁共振扩散加权成像在乳腺良恶性病变中的诊断价值。方法收集我院2010年2—8月经手术病理证实或穿刺活检证实的50例乳腺癌患者和50例乳腺良性病变患者。DWI扫描b值分别为400、600、8001、000 s/mm2,测量病灶区域的ADC值,并比较各组之间的差异。结果 b值分别为400、6008、001、000时乳腺癌及良性病变的ADC值,恶性组ADC值明显低于良性组(P<0.05)。四组不同b值的良恶性病变分别做ROC曲线,以b=1 000 s/mm2时,AUC最大,诊断价值最高,以ADC值为1.23×10-3mm2/s作为良恶性病变的诊断阈值,敏感性为90.0%,特异性为89.8%,准确性为89.9%。结论 DWI结合ADC值测量,对乳腺良恶性病变的鉴别诊断具有较高的临床应用价值。     

The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions

Objectives

To investigate the role of diffusion-weighted MRI (DWI) in the diagnosis of urinary bladder (UB) tumours by means of measuring apparent diffusion coefficient (ADC) values.

Methods

A total of 83 people aged between 18 and 86 years were included in the study: 63 patients with UB pathology (46 malignant, 17 benign) constituted the case group; 20 individuals without any UB pathology constituted the control group. DWI was applied to all individuals. The ADC values were measured based on the tissue of the UB mass entities and normal UB wall in the control group.

Results

The mean ADC value in the UB carcinoma group was significantly lower than that in the control group: 1.0684 ± 0.26 × 10⁻³ mm² s^–1 and 2.010 ± 0.11 × 10⁻³ mm² s^–1, respectively (p<0.01). There was a significant difference among the mean ADC values of different grades of malignant tumours, corresponding to 0.9185 ± 0.20 mm² s^–1 and 1.281 ± 0.18 mm² s^–1 in high-grade and low-grade malignant UB carcinomas, respectively (p<0.01). The ADC value in the carcinoma group was significantly lower than that in the benign lesion group: 1.0684 ± 0.26 × 10⁻³ mm² s^–1 and 1.803 ± 0.19 × 10⁻³ mm² s^–1, respectively (p<0.01). All 46 malignant lesions displayed a restriction in diffusion; 4 of the 17 benign lesions displayed a mild restriction in diffusion. The sensitivity, specificity and accuracy of DWI in the diagnosis of malignant UB lesions was 100%, 76.5% and 93.65%, respectively.

Conclusion

DWI can be beneficial in the differentiation of benign and malignant UB lesions, as well as of high-grade and low-grade UB carcinomas, using quantitative ADC measurements.In recent years, a number of different MRI methods together with conventional ones have been used as part of a routine radiodiagnostic application. Diffusion-weighted MRI (DWI) is considered to be such an imaging method, evaluated within the context of functional MRI and based on the measurement of the accelerated or decelerated microscopic diffusion movements in the protons of the tissues'' water molecules. Images can be obtained in short-period snapshots and do not require any contrast [1-4].The use of DWI had previously been limited to brain examinations because it is sensitive to cardiac, respiratory and peristaltic movements; however, it has been adopted for a much broader use, i.e. for other parts of the body, with the development of fast MRI sequences such as echoplanar imaging (EPI). In early studies, the diffusion-weighted images and the apparent diffusion coefficient (ADC) of tissues and lesions were measured, and the different values obtained were shown to be useful in the differential diagnosis. In later studies, it was reported that ADC vales were related to the cellular intensity of a tumour, and a significant reduction in ADC indicated a malignant tumour [1-4].In DWI studies conducted on patients with head and neck lesions, the mean ADC level was significantly lower in malignant lymphomas, moderately low in patients with carcinomas, moderately high in those with a benign solid masses and markedly higher in those with benign cystic lesions [5].In recent years, DWI has been adopted for widespread use in abdominal examinations. In DWI studies conducted on liver masses, patients with metastatic lesions and hepatocellular carcinoma showed significantly lower ADC levels, those with cavernous haemangiomas showed moderately higher ADC levels, and those with cysts showed markedly higher ADC levels [6].There are also studies reporting that benign renal tumours have much higher ADC values than malignant tumours, and that cystic renal lesions have much higher ADC values than benign solid renal tumours [7].Various researchers in different studies have pointed out that DWI can be an important diagnostic tool in the detection and characterisation of tumours in different regions such as breast, prostate, bladder, cervix, colon, ovary, pancreas and liver. In these studies, it was also indicated that malignant tumours showed much more diffusion restriction and much lower ADC levels than benign tumours owing to their cellularity [8,9].Although DWI studies conducted on bladder masses have not been reported on a broader scale, there has been an increasing tendency to conduct such studies recently. In these studies, the mean ADC levels in bladder tumours have been compared with the surrounding soft tissues and statistically significant results have been obtained. ADC levels in bladder carcinomas were found to be significantly lower than those of the surrounding soft tissues. DWI was also found to have a high sensitivity and specificity in the detection of bladder tumours [10,11].In this study, the mean ADC values obtained from malignant and benign urinary bladder wall pathologies in patients referred to our clinic with a prediagnosis of bladder tumour were compared with the mean ADC values of normal bladder wall in the control group. Also, the ADC levels of the histopathological subgroups of patients with urinary bladder carcinomas were compared among each other. Our aim was to investigate whether DWI could be used in the differentiation of malignant and benign urinary bladder lesions, and whether ADC values found in malignancies could provide any information about the nature of the malignant masses, and thus to research the diagnostic contribution of DWI in standard treatment protocols.     

常规MRI结合DWI在良恶性脑膜瘤鉴别诊断中的应用

目的：探讨常规MRI结合扩散加权成像（DWI）在良、恶性脑膜瘤鉴别诊断中的临床应用。方法：对56例良性（Ⅰ级）、11例非典型性（Ⅱ级）和4例间变性脑膜瘤（Ⅲ级）患者行常规MRI和DWI检查,所有病例均经手术和病理证实。结果：①良、恶性脑膜瘤的最常见部位均位于额部;两者在肿瘤大小、形态和信号特点等方面均无明显差异;但恶性脑膜瘤在肿瘤囊变坏死、边缘不规整、周围水肿、肿瘤强化方式和脑膜尾征等征象发生率上明显高于良性脑膜瘤,两者之间差异有明显统计学意义;肿瘤侵犯脑实质或（和）破坏周围颅骨是诊断恶性脑膜瘤较为特异性征象;②良、恶性脑膜瘤的扩散系数（ADC）值分别为（8.73±1.68）×10^-9mm^2/s、（7.26±3.22）×10^-9mm^2/s,两者之间差异存在显著性意义。结论：常规MRI对于良恶性脑膜瘤的鉴别诊断有一些特征性征象,结合ADC值的变化,能明显提高对于良恶性脑膜瘤的鉴别诊断。     

IVIM成像与DWI在乳腺良恶性病变鉴别诊断中的比较

目的 比较体素内不相干运动(IVIM)成像双指数模型、拉伸指数模型与扩散加权成像(DWI)单指数模型各参数在乳腺良恶性病变鉴别诊断中的价值.方法 回顾性分析257例经病理证实的乳腺病变患者(共276个病灶,包括197个恶性病变,79个良性病变).所有患者均行MRI常规检查及多b值DWI检查,获得传统DWI及IVIM各参数.比较各参数在正常乳腺组织、乳腺良性病变及恶性病变中的统计学差异,采用受试者工作特征(ROC)曲线确定各参数诊断乳腺恶性病变的阈值以及曲线下面积(AUC)、诊断敏感性和特异性.结果 正常乳腺组织、乳腺良性病变及恶性病变的表观扩散系数(ADC)、慢速表观扩散系数(slow ADC)、快速表观扩散系数(fast ADC)、灌注分数(f)、扩散分布指数(DDC)及扩散异质性指数(α)值均有统计学差异(P<0.001).ADC、slow ADC、f、DDC和α的AUC分别为0.865、0.861、0.742、0.85和0.735;ADC、slow ADC、DDC和α的最佳诊断阈值分别为1.105×10-3 mm2/s,0.883×10-3 mm2/s,1.025×10-3 mm2/s和0.842,slow ADC敏感性最高(90.3%),DDC特异性最高(79.5%).双指数模型中slow ADC与fast ADC联合诊断的AUC为0.882;拉伸指数模型DDC与α联合诊断的AUC为0.853.结论 3种模型对于乳腺病变良恶性的鉴别都具有较高的价值,传统ADC的诊断准确性较高,slow ADC敏感性较高,DDC特异性较高.双指数模型中slow ADC与fast ADC联合诊断具有较高的价值.     

磁共振动态增强定量灌注成像方法对子宫良恶性病变的鉴别作用

目的 探讨磁共振动态增强定量灌注成像方法在子宫良恶性病变鉴别诊断中的价值.方法 回顾性分析首诊经病理证实为子宫恶性肿瘤18例(恶性病变组),良性肿瘤或肿瘤样病变22例(良性病变组),及正常子宫肌层25例(正常对照组).均行3.0T磁共振动态增强扫描,并使用SIEMENS TISSUE 4D软件进行图像后处理,采用Tofts药代模型,分别测得感兴趣区的容积定量灌注参数值:容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)值.对3组的定量灌注参数值进行单因素方差分析,多个样本均数的两两比较.结果 3组的灌注参数平均值:Ktrans值分别是恶性病变组(0.178±0.068)min-1、良性病变组(0.182±0.096)min-1、正常对照组(0.263±0.111)min-1;Kep值分别是(0.4±0.101) min-1、(0.378±0.185) min-1、(0,451±0.166) min-1;Ve值分别是0.477±0.143、0.589±0.176、0.613±0.146.恶性病变组平均Ve值比良性病变组低(P=0.037);恶性病变组平均Ktrans及Ve值均较正常对照组低,且两两比较差异有统计学意义(P=0.003、P=0.004).良性病变组平均Ktrans值较正常对照组低,且差别有统计学意义(P=0.011).结论 磁共振定量动态增强参数Ktrans及Ve值对子宫良恶性病变鉴别诊断具有一定的意义.     

MR扩散加权成像鉴别乳腺良恶性病变的研究

目的　探讨磁共振扩散加权成像(diffusion weightedMRimaging, DW MRI)的表观扩散系数(apparentdiffusioncoefficient, ADC)在乳腺病变鉴别诊断中的价值。方法　DW- MRI采用单次激发平面回波成像(echo planarimaging, EPI)技术, 扩散敏感系数(b值)分别为0、500、1000s/mm2。计算26个正常乳腺、手术病理证实的24个恶性病灶、30个良性病灶分别在b=1000~0、1000~500、500~0s/mm2 时的ADC值,比较良恶性病变、正常腺体间ADC值差异的统计学意义及b=1000~0、1000~500、500~0s/mm2 间ADC值差异的统计学意义。结果　乳腺良、恶性病变、正常腺体间ADC值差异均有统计学意义(F= 565. 74,P<0 .01),恶性病变ADC值明显低于良性病变和正常腺体组织,良性病变ADC值明显低于正常腺体组织; 3组b值间ADC值差异均有统计学意义(F=21. 30,P<0 .01),b值越低,ADC值越大;把恶性肿瘤ADC值95%可信区间上界( 1. 01×10-3 )mm2 /s定为良恶性病变鉴别的界值,诊断敏感性为64 .0%,特异性为96 .7%。结论　根据ADC值可以对乳腺良恶性病变做出鉴别诊断,其特异性较高,但敏感性较低。     

扩散峰度成像与DWI在卵巢实性病灶良恶性鉴别诊断中的应用

目的:探讨扩散峰度成像(DKI)与DWI在卵巢实性病灶良恶性鉴别诊断中的应用价值.方法:回顾性分析87例卵巢实性病灶的临床及影像资料,患者均行卵巢MRI常规平扫、DWI、DKI检查,分别获取ADC值、平均扩散峰度(MK)和平均扩散率(MD),评估DWI、DKI对卵巢良恶性病变的鉴别诊断价值.结果:与卵巢恶性病变相比,卵...     

常规超声在乳腺病灶良恶性鉴别中的临床应用价值

目的 探讨常规超声在乳腺病灶良恶性鉴别中的临床应用价值.方法 对94例乳腺肿块患者进行超声检查,将所得的二维及彩色多普勒声像图特征与手术病理检查结果进行对比分析.结果 对超声检查方法与病理诊断符合情况分析发现,超声检查发现良性肿块61例,诊断符合率为88.41％（61/69）;超声检查发现恶性肿块23例,诊断符合率为92.00％（23/25）;对良性组和恶性组的诊断符合率进行统计学分析发现两组的诊断符合率无统计学差异（x2=0.39,P＞0.05）.良性组和恶性组在二维超声声像图方面有明显不同,其中良性组的二维超声声像图多以界限清楚,有包膜,形态规则,内部回声较均匀,后方无衰减,而恶性组的二维超声声像图则多以边界欠清楚或不清楚,无包膜,形态不规则,内部回声不均匀,后方存在衰减.结论 彩色多普勒超声对乳腺良、恶性病变的形态学检查有重要鉴别诊断价值,二维灰阶声像图的特征是乳腺肿块的首要诊断依据.