CAJ | 학술논문

目的探讨扩散加权成像(DWI)中表观弥散系数(ADC)和相对表观弥散系数(rADC)对乳腺恶性肿瘤的诊断价值.方法对53例进行乳腺疾病初诊的女性患者的66个病灶,应用单次激发自旋回波-平面回波序列(SE-EPI)进行扫描,在相同的感兴趣区(ROI)下,分别于扩散敏感系数(b)为500和800 s/mm~2.时,测量病灶及同侧远隔部位正常乳腺腺体的ADC值,并计算rADC值.根据受试者工作特性曲线(ROC),确定鉴别乳腺良、恶性病变的最佳ADC和rADC阈值,评价不同b值下,各阈值鉴别诊断乳腺良、恶性病变的敏感度、特异度和准确率.结果当b值为500 s/mm~2时.良、恶性病灶对应的ADC值分别为(1.71±0.31)×10~(-3)mm~2/s和(1.31±0.38)×10~(-3) mm~2/s,诊断乳腺恶性肿瘤的最佳ADC阈值为1.435×10~(-3)mm~2/s,其诊断的敏感度为82.1%,特异度为81.5%;最佳rADC阈值为0.62,其诊断的敏感度为76.9%,特异度为100%.当b值为800 s/mm.时,良、恶性病灶的ADC值分别为(1.55士0.29)×10~(-3)mm~2/s和(1.14±0.29)×10~(-3)mm~2/s,诊断乳腺恶性肿瘤的最佳ADC阈值为1.295×10~(-3)mm~2/s,其诊断的敏感度为79.5%,特异度为81.5%;最佳rADC阈值为0.71时,诊断的敏感度为89.7%,特异度为88.9%.当b值为800 s/mm~2、rADC的诊断阈值为0.71时,ROC曲线下面积最大.结论 DWI扫描时间短,无需对比剂.ADC和rADC作为诊断指标,其敏感度、特异度均较高,尤其是rADC,对乳腺恶性肿瘤的诊断具有较高的临床应用价值.
목적 탐토확산가권성상(DWI)중표관미산계수(ADC)화상대표관미산계수(rADC)대유선악성종류적진단개치.방법 대53례진행유선질병초진적녀성환자적66개병조,응용단차격발자선회파-평면회파서렬(SE-EPI)진행소묘,재상동적감흥취구(ROI)하,분별우확산민감계수(b)위500화800 s/mm~2.시,측량병조급동측원격부위정상유선선체적ADC치,병계산rADC치.근거수시자공작특성곡선(ROC),학정감별유선량、악성병변적최가ADC화rADC역치,평개불동b치하,각역치감별진단유선량、악성병변적민감도、특이도화준학솔.결과 당b치위500 s/mm~2시.량、악성병조대응적ADC치분별위(1.71±0.31)×10~(-3)mm~2/s화(1.31±0.38)×10~(-3) mm~2/s,진단유선악성종류적최가ADC역치위1.435×10~(-3)mm~2/s,기진단적민감도위82.1%,특이도위81.5%;최가rADC역치위0.62,기진단적민감도위76.9%,특이도위100%.당b치위800 s/mm.시,량、악성병조적ADC치분별위(1.55사0.29)×10~(-3)mm~2/s화(1.14±0.29)×10~(-3)mm~2/s,진단유선악성종류적최가ADC역치위1.295×10~(-3)mm~2/s,기진단적민감도위79.5%,특이도위81.5%;최가rADC역치위0.71시,진단적민감도위89.7%,특이도위88.9%.당b치위800 s/mm~2、rADC적진단역치위0.71시,ROC곡선하면적최대.결론 DWI소묘시간단,무수대비제.ADC화rADC작위진단지표,기민감도、특이도균교고,우기시rADC,대유선악성종류적진단구유교고적림상응용개치.
Objective The aim of this study was to evaluate the value of diffusion weighten imaging (DWI)in the diagnosis of patients with breast diseases.Methods Fifry-three conecutive patients were scanned with GE signa HDx 1.5 T magmetic resonance system equipped with 8-channel breast coil.DWI was scanned by SE-EPI sequence in b values of 500 s/mm~2 and 800 s/mm~2,respectively.The apparent diffusion coeffcients(ADC)of these lesions were measured.The mean apparent diffusion coefficients(ADC)of these lesions were calculated in b values of 500 s/mm~2 and 800 s/mm~2.respectively.These lesions'ADC value(rAOC)was counted respectively and the result of the rADC was equal to the lesion's ADC divided by the ADC of the ipsilateral normal breast tissue.Threshold of ADC and rADC for differential diagnosis was acquired by ROC(receiver operating characteristic curve) analysis.Different imaging teehnologies were evaluated emphasizing their sensitivity,specificity and accuracy.Results Sixty-six lesions of 53 cases were confirmed by pathology,including 39 malignant lesions and 27 benign lesions.(1)b=500 s/mm~2,the threshold of ADC value was 1.435×10~(-3)mm~2/s,with a sensitivity of 82.1% and a speeificity of 81.5%.The threshold of rADC value was 0.62,with a sensitivity of 76.9% and a specificity of 100%.(2)b= 800 s/mm~2,the threshold of ADC value waft 1.295 × 10~(-3)mm~2/s,with a sensitivity of 79.5%and a specificity of 81.5%.The threshold of rADC value was 0.71,with a sensitivity of 89.7% and specificity of 88.9%.(3)The area under the ROC cirve was increased for the four diagnostic indicators(ADC_(500),ADC_(800),rADC_(500),rADC_(800)).Condusion DWI spends short time,and it doesn't need contrast material.ADC value and rADC value have a high sensitivity and specificity as a diagnostic indicator.DWI is helpfulin improving the specificity of MR and may become one of valuable conventional procedures for breast tumor diagnosis.