T磁共振扩散加权成像在乳腺良恶性病变鉴别诊断中价值.docVIP

3.0T磁共振扩散加权成像在乳腺良恶性病变鉴别诊断中的价值 【摘要】 目的 探讨磁共振扩散加权成像(DWI)在乳腺良恶性病变鉴别诊断中的价值。 方法 选择10例正常乳腺、20例乳腺良性病变和32例乳腺癌患者为研究对象。采用3.0 T MRI扫描仪，行SE序列和DWI。b值分别取0，50，200，500，800，1200s/mm2。比较正常组、良性和恶性病变组的磁共振表现，测量其ADC值并进行统计学分析。 结果 (1)乳腺占位性病变在DWI上大多为高信号(48/60，80%)，随着b值升高病灶DWI信号下降，恶性病变的下降程度低于良性病变。(2)b值不同时，各组所取得的ADC值因b值不同而不同，且之间差异具显著性意义。(3)当b=1200～0s/mm2时，恶性病变组平均ADC值为(0.94±0.09)×10-3mm2/s，良性病变组平均ADC值为(1.57±0.14)×10-3mm2/s，正常组平均ADC值为(1.77±0.17)×10-3mm2/s。同一b值，正常组、良性组和恶性组分别对应的ADC值间差异具显著性意义。(4)以病理诊断为金标准，取ADC值≤0.97×10-3mm2/s(b= 1200～0s/mm2)作为诊断乳腺恶性病变的阈值，其诊断敏感性83.78%，特异性91.30%，准确性86.96%，与病理诊断的一致性较好(Kappa值=0.73，Plt;0.001)。 结论 DWI结合ADC值测量,对乳腺良恶性病变的鉴别诊断具有较高的临床应用价值。 【关键词】 磁共振成像; 扩散加权　成像; 乳腺病变 [Abstract] Objective To evaluate the clinical value of diffusion weighted imaging (DWI) for the diagnosis of breast lesions at 3.0 Tesla MRI. Methods To choose 10 cases of normal breases, 20 benign lesions and 37 malignant ones were observed. The statistical differences of ADC values calculated respectively with b values of 1200 and 0 s/mm2, 800 and 0 s/mm2, 500 and 0 s/mm2 in normal breasts, malignant breast lesions and benign ones were analyzed in order to find out the differential diagnosis value of ADC values in breast lesions. They were also calculated and compared to obtain an applicable b value in diagnosis for breast lesions at 3.0 Tesla MRI. Results (1)Of breast lesions on DWI were mostly in the high signal (48/60, 80%), with the b value increased DWI signal lesions decreased, the decline in the extent of malignant lesions than benign lesions.(2)There were significant statistically differences of ADC values in normal breast, benign and malignant lesions as well as ADC values calculated with different b values. (3)When b=1200 ~ 0s/mm2 the malignant lesions average ADC value was(0.94±0.09) ×10-3mm2/s,benign lesion group as the average ADC value was(1.57±0.14)×10-3mm2/s. The average ADC value (1.77±0.17)×10-3mm2/s.The same normal b value,benign and malignant groups,the corresponding difference between ADC