DWI结合时间-信号强度曲线评价乳腺病变性质的研究

目的：探讨MR扩散加权成像结合时间-信号强度曲线在评价乳腺病变性质上的应用价值。方法：对117例乳腺病患者的134处病灶同时行MR扩散加权成像（b值=800s／mm^2）和多时相增强MRI扫描。分别总结依据ADC值和时间-信号强度曲线评价乳腺良、恶性病变的统计学意义。统计综合考虑ADC值和时间-信号强度曲线类型评价乳腺良、恶性病变的敏感度、特异度和准确度。结果：以1．20×10^-3mm^2／s作为界值评价乳腺病变的性质，具有明显的统计学意义（P〈0．05）；以Ⅰ型曲线诊断乳腺良性病变，以Ⅱ、Ⅲ型曲线诊断乳腺癌，具有明显统计学意义（P〈0．05）。如单纯以ADC值≤〉1．20×10^-3mm^2／s且时间-信号强度曲线上表现为Ⅱ、Ⅲ型曲线来判定乳腺癌，而以ADC值〉1．20×10^-3mm^2／s且时间-信号强度曲线上表现为Ⅰ型曲线来判定乳腺良性病变，敏感度为82．7％，特异度69．8％，准确度77．6％。结论：应用DWI和时间-信号强度曲线对乳腺病变的良恶性进行评价具有重要价值。

Application of both MR diffusion weighted imaging and time -signal intensity curve in appraising breast Lesions

Objective：To investigate the clinical values to differentiate benign from malignant breast lesions by both MR Diffusion weighted imaging（DWI） and time -signal intensity curve （T- SI curve）. Methods： All 117 patients with 134 breast lesions had been examined by both DWI（ b = 800s/mm^2） and dynamic MR contrast -enhanced scanning. The statistic values of ADC and T - SI curve were studied in diagnosing breast lesions. The sensitivity, specificity and accuracy of diagnosing breast lesions by both DWI and T - SI curve were also studied. Results： It was sta- tistically valuable to differentiate benign from malignant breast lesions not only by the values of ADC but also by T - SI curve respectively （ P 〈 0.05 ）. If taking both the values of ADC ≤ 1.20 × 10^- 3 mm^2/s and the type Ⅱ ＋ Ⅲ of T - SI curve together as the only standard to appraising breast carcinoma, and taking both the values of ADC 〉 1.20 × 10^-3 mm^2/s and the type I of T- SI curve together as the only standard to appraising breast malignant lesions ,sensitivity was 82.7% specificity 69.8% and accuracy 77.6%. Conclusion： It is helpful to differentiate breast malignant and benign lesions by combining DWI and T- SI curve.