国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2011年
3期
189-192,封3
,共5页
杨晓棠%杨继虎%杜笑松%张建新
楊曉棠%楊繼虎%杜笑鬆%張建新
양효당%양계호%두소송%장건신
乳腺病变%磁共振成像,弥散%磁共振成像%表观扩散系数
乳腺病變%磁共振成像,瀰散%磁共振成像%錶觀擴散繫數
유선병변%자공진성상,미산%자공진성상%표관확산계수
Breast lesions%Diffusion on magnetic resonance imagingk%Magnetic resonance imaging: Aoparent diffusion coefficient
目的 探讨月经周期对正常乳腺实质磁共振扩散加权成像(DWI)表观扩散系数(ADC)值的影响，并评价动态增强MRI(DCE-MRI)及DWI在乳腺病变鉴别诊断中的价值。方法 选取健康女性志愿者34例、乳腺病变患者96例，所有病例均经外科手术或针吸病理证实，其中良性病变者36例，共44个病灶；恶性病变者60例，共70个病灶。对34例健康志愿者分别于其月经周期的第1、2、3、4周行T1加权MRI、T2加权MRI及DWI。对96例乳腺病变患者的114个病灶分别于术前行T1加权MRI、T2加权MRI、液体衰减反转序列MRI、DCE-MRI及DWI。结果 ①正常乳腺的ADC值在月经周期的第2周降至最低，后缓慢升高，各周均值之间比较的差异无统计学意义(F=1.029，P＞0.05）。②在DCE-MRI的诊断中，Ⅲ型曲线是典型乳腺癌的影像表现，Ⅰ型和Ⅳ型曲线对诊断乳腺良性病变有意义。③当b值为1000 s/mm2时，良恶性乳腺病变的ADC诊断阈值是1.25×10-3 mm2/s。结论在乳腺DWI中，月经周期对正常乳腺实质的ADC值影响较小。DCE-MRI和DWI对乳腺良恶性病变的诊断和鉴别诊断具有重要价值。
目的 探討月經週期對正常乳腺實質磁共振擴散加權成像(DWI)錶觀擴散繫數(ADC)值的影響，併評價動態增彊MRI(DCE-MRI)及DWI在乳腺病變鑒彆診斷中的價值。方法 選取健康女性誌願者34例、乳腺病變患者96例，所有病例均經外科手術或針吸病理證實，其中良性病變者36例，共44箇病竈；噁性病變者60例，共70箇病竈。對34例健康誌願者分彆于其月經週期的第1、2、3、4週行T1加權MRI、T2加權MRI及DWI。對96例乳腺病變患者的114箇病竈分彆于術前行T1加權MRI、T2加權MRI、液體衰減反轉序列MRI、DCE-MRI及DWI。結果 ①正常乳腺的ADC值在月經週期的第2週降至最低，後緩慢升高，各週均值之間比較的差異無統計學意義(F=1.029，P＞0.05）。②在DCE-MRI的診斷中，Ⅲ型麯線是典型乳腺癌的影像錶現，Ⅰ型和Ⅳ型麯線對診斷乳腺良性病變有意義。③噹b值為1000 s/mm2時，良噁性乳腺病變的ADC診斷閾值是1.25×10-3 mm2/s。結論在乳腺DWI中，月經週期對正常乳腺實質的ADC值影響較小。DCE-MRI和DWI對乳腺良噁性病變的診斷和鑒彆診斷具有重要價值。
목적 탐토월경주기대정상유선실질자공진확산가권성상(DWI)표관확산계수(ADC)치적영향，병평개동태증강MRI(DCE-MRI)급DWI재유선병변감별진단중적개치。방법 선취건강녀성지원자34례、유선병변환자96례，소유병례균경외과수술혹침흡병리증실，기중량성병변자36례，공44개병조；악성병변자60례，공70개병조。대34례건강지원자분별우기월경주기적제1、2、3、4주행T1가권MRI、T2가권MRI급DWI。대96례유선병변환자적114개병조분별우술전행T1가권MRI、T2가권MRI、액체쇠감반전서렬MRI、DCE-MRI급DWI。결과 ①정상유선적ADC치재월경주기적제2주강지최저，후완만승고，각주균치지간비교적차이무통계학의의(F=1.029，P＞0.05）。②재DCE-MRI적진단중，Ⅲ형곡선시전형유선암적영상표현，Ⅰ형화Ⅳ형곡선대진단유선량성병변유의의。③당b치위1000 s/mm2시，량악성유선병변적ADC진단역치시1.25×10-3 mm2/s。결론재유선DWI중，월경주기대정상유선실질적ADC치영향교소。DCE-MRI화DWI대유선량악성병변적진단화감별진단구유중요개치。
Objective To explore the relationship between the menstrual cycle and apparent diffusion coefficient(ADC) values of MR diffusion weighted imaging(DWI).To investigate the evaluation of DWI and dynamic contrast-enhanced MRI(DCE-MRI) in distinguishing benign from malignant breast lesions.Methods Thirty-four healthy, premenopausal female volunteers who had regular menstrual cycles and 96breast disease patients who proved by surgery or Needle aspiration pathology were included in the study.Of the 96 patients, there were 36 cases with 44 benign breast lesions and 60 cases with 70 malignant breast lesions.The healthy volunteers were scanned by conventional T1 weighted MRI, T2 weighted MRI and DWI once a week for 4 weeks with Siemens Sonata 1.5T MRI(b=1000s/mm2).The patients were examined by conventional MRI, DCE-MRI and DWI.DWI using Echo planar imaging technique and frequency selection suppression technology were used in DWI(b=1000 s/mm2)and fast low angle shot sequence was used in DCE-MRI.The data of DWI and DCE-MRI were sent to Leonardo workstation.Results ①ADC values of normal breast in the second week of the menstrual cycle reduced to minimum and then slowly increased, a comparison between the mean was not significant (F=1.029, P＞0.05).② In DCE-MRI, type Ⅲ curve is the typical type of breast cancer, type Ⅰ and Ⅳ curve are the typical type of breast benign lesions.③When b=1000 s/mam2, the diagnostic threshold of ADC values between the benign breast lesions and malignant lesions was 1.25×10-3 mm2/s.Conclusions ADC values were less influenced by the menstrual cycle in normal breasts.The specificity and accuracy in the diagnosis of benign and maglinant breast lesions were improved with the combination of DCE-MRI and DWI.
