磁共振成像扩散加权序列与超声及钼靶摄影对乳腺疾病的诊断价值比较

目的：探讨磁共振成像扩散加权序列（ DWI）在乳腺疾病诊断中的价值，并与钼靶摄影及超声进行比较。方法回顾性分析经手术后病理证实的28例乳腺病变的术前DWI、钼靶摄影及超声的诊断准确率，测定表面扩散系数（ADC值），并做相关统计学分析。结果（1）DWI扫描：恶性病变诊断准确率90．9％（20/22），恶性病变ADC值为（0．955±0．199）×10^ -3 mm^2/s；良性病变诊断准确率83．3％（5/6），ADC值为（1．660±0．339）×10^ -3 mm^2/s，两者ACD值差异有统计学意义（t＝2．371，P＜0．05）。（2）钼靶摄影：恶性病变诊断准确率81．8％（18/22）；良性病变诊断准确率33．3％（2/6）。（3）超声检查：恶性病变诊断准确率86.4％（19/22）；良性病变诊断准确率50．0％（3/6）。三种检查方法对于乳腺恶性肿瘤诊断准确率差异均无统计学意义（χ2＝0．752，P＞0．05），但在良性病变诊断准确率方面DWI序列明显好于钼靶摄影及超声检查，差异有统计学意义（χ2＝6．146，P＜0．05）。结论 DWI序列对于发现乳腺病变以及在良恶性诊断方面优于钼靶摄影及超声检查，具有良好的临床应用价值。

Comparison of the diagnostic value of MRI diffusion weighted imaging with ultrasound and mammography in the breast disease

Objective To explore the clinical value of diffusion weighted imaging （DWI） in the diagnosis of breast disease ,and compared with ultrasound and mammography .Methods The clinical data of 28 patients who were＆amp;nbsp;pathologically confirmed with breast cancer were retrospectively reviewed .The diagnostic accuracy of DWI ,mammogra-phy and ultrasound , the surface diffusion coefficients （ ADC value ） were statistically analyzed .Results （ 1 ） DWI scan：the diagnostic accuracy of malignant tumor was 90.9%（20/22）,the ADC value of malignant tumor was （0.955 ±0.199） ×10^ -3mm^2/s;the diagnostic accuracy of benign lesions was 83.3%（5/6）,the average ADC value of benign lesions was （1.660 ±0.339） ×10^ -3 mm^2/s,there were statistically significant differences （ t=2.371,P〈0.05）.（2）Mammography：the diagnostic accuracy of malignant tumor was 81.8%（18/22）,the diagnostic accuracy of benign lesions was 33.3%（2/6）.（3） Ultrasound：the diagnostic accuracy of malignant tumor was 86.4%（19/22）,the diagnostic accuracy of benign lesions was 50.0%（3/6）.The diagnostic accuracy of malignant tumor had no significant difference among three techniques （χ^2 =0.752,P〉0.05）,but for the diagnostic accuracy of benign lesions,DWI was better than ultrasound and mammography ,the difference was statistically significant （χ2 =6.146, P〈0.05）.Conclusion For the diagnosis of malignant breast tumors and benign lesions ,DWI is better than ultra-sound and mammography ,which has high clinical application value .