30T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.doc

30T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 正文 30T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 文1：30T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 [Abstract] Objective To evaluate the clinical value of diffusion weighted imaging (DWI) for the diagnosis of breast lesio at Tesla MRI. Methods To choose 10 cases of normal breases， 20 benign lesio 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 lesio and benign ones were analyzed in order to find out the differential diagnosis value of ADC values in breast lesio. They were also calculated and compared to obtain an applicable b value in diagnosis for breast lesio at Tesla MRI. Results (1)Of breast lesio on DWI were mostly in the high signal (48/60， 80%)， with the b value increased DWI signal lesio decreased， the decline in the extent of malignant lesio than benign lesio.(2)There were significant statistically differences of ADC values in normal breast， benign and malignant lesio as well as ADC values calculated with different b values. (3)When b=1200 ~ 0s/mm2 the malignant lesio average ADC value was(±) ×10-3mm2，benign lesion group as the average ADC value was(±)×10-3mm2. The average ADC value (±)× same normal b value，benign and malignant groups，the corresponding difference between ADC values of significant.(4)Diagnosed as a pathological standard， ADC values from ≤×10-3mm2 (b = 1200~0s/mm2) malignant breast lesio as a diagnostic threshold， its diagnostic seitivity of %， % specificity， accuracy %， and better coistency of pathological diagnosis (Kappa value=， P [Key words] breast lesio; magnetic resonance imaging(MRI); diffusion weighted imaging(DWI) 乳腺癌是女性最常见的恶性肿瘤之一，早期发现、早期诊断是降低死亡率、提高生活质量的关键。近年来技术在乳腺的应用不断成熟，但关于超高场强()的应用[1]少有报道。笔者应用磁共振扫描仪，探讨磁共振扩散加权成像对乳腺病变最有诊断意义的b值及良恶性病变ADC阈值。 材料与方法 1.研究对象 取2007年2月～2008年3月间临床触及乳腺肿物，钼靶或超声检出病灶但部分定性困难的女性患者52例共60个病灶行磁共振DWI及DCE-MRI检查。良性病灶23个，其中纤维腺瘤10个，腺体增生并纤维腺瘤形成8个，导管内乳头状瘤2个，结核性肉芽肿1个，囊肿2个;年龄