| 乳腺MR动态增强扫描联合扩散加权成像的临床应用评价 |
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| 引用本文： | 李洁,张晓鹏,曹崑,唐磊,孙应实,单军,欧阳涛.乳腺MR动态增强扫描联合扩散加权成像的临床应用评价[J].中国医学影像技术,2005,21(12):1821-1825. |
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| 作者姓名： | 李洁 张晓鹏 曹崑 唐磊 孙应实 单军 欧阳涛 |
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| 作者单位： | 1. 北京大学临床肿瘤学院暨北京肿瘤医院放射科,北京,100036
2. 北京大学临床肿瘤学院暨北京肿瘤医院乳腺外科,北京,100036 |
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| 摘 要： | 目的探讨动态增强扫描联合扩散加权成像对乳腺病变定性诊断临床应用价值.方法35例临床或钼靶X线可疑恶性发现的病人,获得病理证实的41个病灶,其中良性病灶13个,恶性病灶28个.同时进行动态增强扫描和扩散加权成像,MR扫描采用3D快速扰相位梯度回波(FSPGR)和单次激发EPI,b*1000 s/mm2.由两名医生共同在ADW工作站Functool 2软件进行图像分析,观察病变形态和动态增强表现,绘制时间-信号强度曲线,根据病变的形态特征、时间-信号强度曲线采用评分法对病变性质进行判断,分为恶性,可疑恶性及良性三种.参照动态增强病变位置确定扩散图像病变所在,描记扩散图像上病变的感兴趣区,由软件计算获得表观扩散系数(ADC)值.采用ROC曲线法确定ADC值的诊断阈值,并进行性质判断.联合动态增强扫描和ADC值,采用评分法根据积分情况进行综合定性诊断.比较动态增强扫描、DWI ADC值及联合应用对乳腺病变定性诊断效能.结果动态增强扫描(病灶形态学表现结合时间-信号强度曲线)诊断乳腺病变的敏感性、特异性和准确性分别为96.4%(26/27)、61.5%(8/13)和85.4%(35/41).ROC曲线分析确定ADC诊断阈值为1.42×10-3 mm2/s,曲线下面积为0.690.ADC值诊断敏感性、特异性和准确性分别为89.3%(25/28)、61.5%(8/13)和80.5%(33/41).动态增强扫描和DWI-ADC值联合诊断的敏感性、特异性和准确性分别为89.3%(25/28)、76.9%(10/13)和85.4%(35/41).有50%(14/28)的恶性病灶动态增强扫描表现不典型,通过ADC值得到进一步确定诊断.结论动态增强扫描联合扩散加权成像有助于提高乳腺病变定性诊断的特异性,可为动态增强扫描不能确定诊断的病灶提供更有价值的信息.
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| 关 键 词： | 乳腺 磁共振成像 动态 对比增强 扩散加权成像 |
| 文章编号： | 1003-3289（2005）12-1821-05 |
| 收稿时间： | 2005-09-06 |
| 修稿时间： | 2005-11-25 |
Clinical evaluation of combining dynamic contrast-enhanced MR imaging and diffusion-weighted MR imaging for diagnosis of breast lesion |
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| LI Jie,ZHANG Xiao-peng,CAO Kun,TANG Lei,SUN Ying-shi,SHAN Jun and OUYANG Tao.Clinical evaluation of combining dynamic contrast-enhanced MR imaging and diffusion-weighted MR imaging for diagnosis of breast lesion[J].Chinese Journal of Medical Imaging Technology,2005,21(12):1821-1825. |
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| Authors: | LI Jie ZHANG Xiao-peng CAO Kun TANG Lei SUN Ying-shi SHAN Jun and OUYANG Tao |
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| Institution: | Department of Radiology, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China;Department of Radiology, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China;Department of Radiology, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China;Department of Radiology, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China;Department of Radiology, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China;Department of Radiology, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China;Department of Breast Surgery, Peking University School of Oncology & Bejing Cancer Hospital, Beijing 100036, China |
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| Abstract: | |
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| Keywords: | Breast Magnetic resonance imaging Dynamic contrast enhancement Diffusion weighted imaging |
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