磁共振扩散加权成像对乳腺癌的诊断价值

目的 探讨磁共振扩散加权成像(DWI)的表观扩散系数(ADC)值对乳腺肿块鉴别诊断价值,提高乳腺癌的诊断特异性.方法 对93例105个乳腺肿块患者行常规MR平扫DWI成像,测量ADC值.结果 37例43个良性病灶的平均ADC值:(1.37±0.36)×10-3 mm2/s,最大、最小ADC差值(0.63±0.19)×10-3mm2/s;58例62个恶性病灶的平均ADC值:(0.90±0.53)×10-3mm2/s,最大、最小ADC差值(0.91±0.27)×10-3 mm2/s;两者平均ADC值,最大、最小ADC差值的差异均有统计学意义(均P＜0.01).绘制诊断良、恶性病变ADC值ROC曲线,以1.1×10-3mm2/s作为临界值作为判断良、恶性的标准,敏感性为67％,特异性为72％；以1.0×10-3mm2/s为临界值,特异性可提高到84％.而敏感度降为60％.以最大、最小ADC差值0.75×10-3mm2/s为临界值,敏感性为67％,特异性为68％,如以0.80×10-3mm2/s为临界值,敏感性为53％,特异性为82％.结论 DWI的ADC值对乳腺良恶性病变的鉴别诊断具有一定的意义.

The diagnosis value of magnetic resonance diffusion weighted imaging for breast cancer

Objective To explore the differential diagnosis value of DWI ADC for breast lumps,improve the diagnosis of breast cancer specificity. Methods 93 patients with 105 breast tumors were performed with routine MR series and DWI, and the ADC values were measured. Results Lesions ADC values ： average ADC value 43 benign lesions in 37 cases was （ 1.37 ± 0. 36 ） ×10-3mm2/s, the different value between max and min was （ 0.63 ± 0.19 ） ×10-3mm2/s. Average ADC value of 62 malignant lesions in 58 patients was（0.90 ± 0.53 ）×10-3mm2/s, the different value between max and min was（ 0.91 ± 0.27 ）×10-3mm2/s. By statistical analysis, both average ADC values and the max and the min ADC difference value were very significantly different（ P 〈 0.01 ）. Draw diagnosis benign and malignant lesions ROC curves, with ADC values 0.11 ×10-3mm2/s for critical value to judge benign and malignant standard,sensitivity was 67%, specificity was 72%. With 1.0 ×10-3mm2/s for critical value, specificity can raise to 84% ,and sensitivity came to 60%. With the maximum and minimum ADC difference value 0.75 ×10-3mm2/s for critical value, sensitivity was 67%, specificity was 68%. If with 0.80 for critical value, sensitivity was 53% and specificity 82%. Conclusion The average ADC values of DWI were significant for the identification of benign and malignant lesions.