磁共振动态增强联合弥散加权成像在乳腺病变的研究-影像医学与核医学专业论文.docxVIP

II万方数据 II 万方数据 摘要 目的：探讨磁共振动态增强及弥散加权成像联合应用在乳腺良、恶性病变鉴别诊断中 的价值 材料与方法：收集经手术病理或穿刺活检病理证实的乳腺病变共33例33个病灶，均行 磁共振动态增强及弥散加权成像检查。将病例分成恶性病变组、非囊肿良性病变组两组病 例，分别测定不同乳腺病变的平均ADC值（Apparent Diffusion Coefficient）及早期强化率， 并绘制时间-信号强度曲线（Time-signal Intensity curve,TIC），比较不同病变的ADC值、 平均早期强化率及时间-信号强度曲线差异。计算ADC值联合早期强化率诊断乳腺良恶性 病变的诊断指标，评估联合利用ADC值及早期强化率对良恶性病变鉴别诊断的价值。 结果：1、乳腺恶性病变的平均ADC值为0.7249±0.09963×10-3mm2/s；非囊肿良性病 变的平均ADC值为1.197±0.2723×10-3mm2/s。两组之间的ADC值具有统计学差异。 2、乳腺良、恶性病变之间的早期强化率及时间-信号强度曲线类型的分布均有统计学 差异。时间-信号强化曲线类型的分布对诊断乳腺病变的敏感性、特异性、准确性分别为 100％、55.56％、75.76％。 3、联合利用ADC值及早期强化率对乳腺病变进行诊断的敏感性为93.33%，特异性为 100%，准确性为96.97%。 结论：1、弥散加权成像可反应病变组织的细胞生物学特性，测定乳腺病灶的ADC值 可作为一种客观、独立的诊断依据来判断乳腺病变的良恶性。 2、磁共振动态增强检查有利于分析乳腺病灶的血流动力学特征，早期强化率及时间- 信号强度曲线均可作为一种独立客观的诊断依据来判断乳腺病变的良恶性。 3、联合利用乳腺病灶的ADC值与早期强化率可有效提高乳腺良恶性鉴别诊断的敏感 性、特异性及准确性，特别是当病灶同一部位同时表现出具有恶性病变特征的早期强化率 及ADC值时，其恶性病变可能性极高。 关键词：磁共振；动态增强成像；弥散加权成像；乳腺疾病 PAGE IV PAGE IV 万方数据 ABSTRACT PURPOSE: To investigate the capability and diagnostic value of combining dynamic-enhanced MR imaging with diffusion-weighted imaging in differentiating benign from malignant breast lesions. MATERIALS AND METHODS: Thirty-three lesions breast lesions in 33 patients were acquired with histopathological demonstration. All lesions were examined with dynamic contrast-enhanced MRI and DWI, which were divided into two groups: malignant and non-cyst benign lesions. Apparent diffusion coefficients (ADC), early enhancement rate and time-signal intensity curve were calculated for each lesion. Two combination diagnosis method for breast lesions which according to the ADC and early enhancement rate were compared in order to investigate diagnostic value of the ADC and early enhancement rate in differentiating benign from malignant breast lesions. RESULTS: Significant results were obtained between ADC values of malignant and non-cyst benign lesions (p 0.000). The mean ADC values for malignant and non-cyst benign lesions were 0.7249±0.09963×10-3mm2/s and 1.197±0.2723×10-3mm2/s, respectively. Early enhance