T2*灌注加权成像联合DWI诊断乳腺良恶性病变

目的 探讨MR T2^* PWI联合DWI对乳腺良恶性病变鉴别诊断价值。方法 回顾性分析经手术病理证实的乳腺良恶性病变74例患者,共84个病灶,患者行常规MR平扫、T2^* PWI和DWI检查。根据MR T2^*首次通过灌注成像绘制时间-信号强度曲线,于ADC图测量病灶的ADC值;计算T2^* PWI的最大下降线性斜率(MSD),并进行统计学分析。计算T2^* PWI、DWI和两者联合对乳腺恶性病变的诊断效能。结果 乳腺良恶性病变的MSD值、ADC值差异均有统计学意义(P均<0.05)。T2^* PWI对乳腺恶性病变的诊断敏感度、特异度、阳性预测值、阴性预测值、ROC曲线下面积分别为90.57%(48/53)、83.87%(26/31)、90.57%(48/53)、83.87%(26/31)、0.87;DWI分别为84.91%(45/53)、74.19%(23/31)、84.91%(45/53)、74.19%(23/31)、0.83;两者联合分别为94.34%(50/53)、90.32%(28/31)、94.34%(50/53)、90.32%(28/31)、0.91。结论 T2^* PWI联合DWI对乳腺良恶性病变具有较高的鉴别诊断价值。

T2* perfusion weighted imaging combined with DWI in diagnosis of benign and malignant breast lesions

Objective To assess the diagnostic value of T2^* PWI combined with DWI in diagnosis of breast lesions. Methods Totally 74 patients with 84 lesions confirmed pathologically were retrospectively analyzed. All patients underwent conventional MR scan, T2^* PWI and DWI. According to first-pass perfusion MR T2^* imaging rendered time-signal intensity curves, ADC value were measured; maximum slope of decrease (MSD) were calculated. The statistical analysis was performed. The diagnosis value of T2^* PWI, DWI, and their combination were also estimated. Results MSD and ADC between benign and malignant breast lesions were statistically significant (all P<0.05). In diagnosis of breast malignancy, the sensitivity, specificity, positive predictive value, negative predictive value, ROC area under the curve of T2^* PWI were 90.57% (48/53), 83.87% (26/31), 90.57% (48/53), 83.87% (26/31), 0.87, of DWI were 84.91% (45/53), 74.19% (23/31), 84.91% (45/53), 74.19% (23/31), 0.83, and of their combination were 94.34% (50/53), 90.32% (28/31), 94.34% (50/53), 90.32%(28/31), 0.91. Conclusion T2^* PWI combined with DWI has high differential diagnosis value for benign and malignant breast lesions.