中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
23期
1804-1807
,共4页
江静%刘万花%叶媛媛%王瑞%李逢芳%彭程宇
江靜%劉萬花%葉媛媛%王瑞%李逢芳%彭程宇
강정%류만화%협원원%왕서%리봉방%팽정우
乳腺疾病%磁共振成像,弥散%信号强度%ADC值
乳腺疾病%磁共振成像,瀰散%信號彊度%ADC值
유선질병%자공진성상,미산%신호강도%ADC치
Breast diseases%Diffusion magnetic resonance imaging%Signal intensity%ADC value
目的：探讨3.0 T MR扩散加权成像不同b值的信号强度及ADC值下降率对乳腺良恶性病变的诊断价值。方法对东南大学附属中大医院自2010年12月至2012年12月经手术病理证实的152例162个乳腺病灶（恶性85灶，良性77灶）行3.0 T MR DWI扫描，b值取0、400、800、1000 s/mm2，分别测量不同b值下乳腺病灶DWI信号强度及ADC值，计算DWI信号强度下降率（SIDR）， SIDR＝（低b值DWI病灶信号强度-高b值DWI病灶信号强度）/低b值DWI病灶信号强度及ADC值下降率（ ADCDR），ADCDR＝（低b值病灶ADC值-高b值病灶ADC值）/低b值病灶ADC值）。对所获得的资料采用两独立样本t检验进行统计学分析并采用ROC曲线评价SIDR值及ADCDR值的诊断效能。结果（1）0～400、400～800和800～1000 s/mm23组b值间良、恶性病灶SIDR差异均有统计学意义（均P＜0.01）。（2）3组b值间的SIDR对良恶性病变诊断的敏感性分别为61.2％、68.2％和67.1％，特异性分别为74.0％、85.7％和67.5％；诊断符合率分别为67.3％、76.5％和67.3％；阳性预测值分别为72.2％、84.1％和69.5％；阴性预测值分别为63.3％、71.0％和65.0％。（3）400～800、800～1000 s/mm2两组 b值间良、恶性病灶ADCDR差异均有统计学意义（均P＜0.01）。（4）两组b值间的ADCDR对良恶性病变诊断的敏感性分别为80.0％、65.9％，特异性分别为72.7％、65.0％；诊断符合率分别为76.5％、65.4％；阳性预测值分别为76.4％、67.5％；阴性预测值分别为76.7％、63.3％。结论不同b值的信号强度下降率及ADC值下降率对乳腺良恶病灶都具有鉴别诊断价值，且诊断效能以400～800 s/mm2间为最佳。
目的：探討3.0 T MR擴散加權成像不同b值的信號彊度及ADC值下降率對乳腺良噁性病變的診斷價值。方法對東南大學附屬中大醫院自2010年12月至2012年12月經手術病理證實的152例162箇乳腺病竈（噁性85竈，良性77竈）行3.0 T MR DWI掃描，b值取0、400、800、1000 s/mm2，分彆測量不同b值下乳腺病竈DWI信號彊度及ADC值，計算DWI信號彊度下降率（SIDR）， SIDR＝（低b值DWI病竈信號彊度-高b值DWI病竈信號彊度）/低b值DWI病竈信號彊度及ADC值下降率（ ADCDR），ADCDR＝（低b值病竈ADC值-高b值病竈ADC值）/低b值病竈ADC值）。對所穫得的資料採用兩獨立樣本t檢驗進行統計學分析併採用ROC麯線評價SIDR值及ADCDR值的診斷效能。結果（1）0～400、400～800和800～1000 s/mm23組b值間良、噁性病竈SIDR差異均有統計學意義（均P＜0.01）。（2）3組b值間的SIDR對良噁性病變診斷的敏感性分彆為61.2％、68.2％和67.1％，特異性分彆為74.0％、85.7％和67.5％；診斷符閤率分彆為67.3％、76.5％和67.3％；暘性預測值分彆為72.2％、84.1％和69.5％；陰性預測值分彆為63.3％、71.0％和65.0％。（3）400～800、800～1000 s/mm2兩組 b值間良、噁性病竈ADCDR差異均有統計學意義（均P＜0.01）。（4）兩組b值間的ADCDR對良噁性病變診斷的敏感性分彆為80.0％、65.9％，特異性分彆為72.7％、65.0％；診斷符閤率分彆為76.5％、65.4％；暘性預測值分彆為76.4％、67.5％；陰性預測值分彆為76.7％、63.3％。結論不同b值的信號彊度下降率及ADC值下降率對乳腺良噁病竈都具有鑒彆診斷價值，且診斷效能以400～800 s/mm2間為最佳。
목적：탐토3.0 T MR확산가권성상불동b치적신호강도급ADC치하강솔대유선량악성병변적진단개치。방법대동남대학부속중대의원자2010년12월지2012년12월경수술병리증실적152례162개유선병조（악성85조，량성77조）행3.0 T MR DWI소묘，b치취0、400、800、1000 s/mm2，분별측량불동b치하유선병조DWI신호강도급ADC치，계산DWI신호강도하강솔（SIDR）， SIDR＝（저b치DWI병조신호강도-고b치DWI병조신호강도）/저b치DWI병조신호강도급ADC치하강솔（ ADCDR），ADCDR＝（저b치병조ADC치-고b치병조ADC치）/저b치병조ADC치）。대소획득적자료채용량독립양본t검험진행통계학분석병채용ROC곡선평개SIDR치급ADCDR치적진단효능。결과（1）0～400、400～800화800～1000 s/mm23조b치간량、악성병조SIDR차이균유통계학의의（균P＜0.01）。（2）3조b치간적SIDR대량악성병변진단적민감성분별위61.2％、68.2％화67.1％，특이성분별위74.0％、85.7％화67.5％；진단부합솔분별위67.3％、76.5％화67.3％；양성예측치분별위72.2％、84.1％화69.5％；음성예측치분별위63.3％、71.0％화65.0％。（3）400～800、800～1000 s/mm2량조 b치간량、악성병조ADCDR차이균유통계학의의（균P＜0.01）。（4）량조b치간적ADCDR대량악성병변진단적민감성분별위80.0％、65.9％，특이성분별위72.7％、65.0％；진단부합솔분별위76.5％、65.4％；양성예측치분별위76.4％、67.5％；음성예측치분별위76.7％、63.3％。결론불동b치적신호강도하강솔급ADC치하강솔대유선량악병조도구유감별진단개치，차진단효능이400～800 s/mm2간위최가。
Objective To investigate the diagnostic efficiency of decline rate of signal intensity and apparent diffusion coefficient with different b values for differentiating benign and malignant breast lesions on diffusion-weighted 3.0T magnetic resonance imaging.Methods A total of 152 patients with 162 confirmed histopathologically breast lesions (85 malignant and 77 benign) underwent 3.0T diffusion-weighted magnetic resonance imaging.Four b values (0, 400, 800 and 1 000 s/mm2 ) were used.The signal intensity and ADC values of breast lesions were measured respectively.The signal intensity decline rate ( SIDR ) and apparent diffusion coefficient decline rate ( ADCDR) were calculated respectively.SIDR=( signal intensity of lesions with low b value-signal intensity of lesions with high b value )/signal intensity of lesions with low b value, ADCDR =( ADC value of lesions with low b value-ADC value of lesions with high b value )/ADC value of lesions with low b value.The independent sample t-test was employed for statistical analyses and the receiver operating characteristic ( ROC) curve for evaluating the diagnosis efficiency of SIDR and ADCDR values.Results Significant differences were observed in SIDR between benign and malignant breast lesions with b values of 0-400, 400-800 and 800 -1 000 s/mm2.The sensitivities of SIDR for differentiating benign and malignant breast lesions were 61.2%, 68.2% and 67.1%, the specificities 74.0%, 85.7%and 67.5%, the diagnosis accordance rates 67.3%, 76.5% and 67.3%, the positive predictive values 72.2%, 84.1%and 69.5%and the negative predictive values 63.3%, 71.0%and 65.0% respectively.Significant differences were observed in ADCDR between benign and malignant breast lesions with b values of 400-800 s/mm2 and 800-1 000 s/mm2.The sensitivities of SDR for differentiating benign and malignant breast lesions were 80.0% and 65.9%, the specificities 72.7% and 65.0%, the diagnostic accordance rates 76.5% and 65.4%, the positive predictive values 76.4% and 67.5% and the negative predictive values 76.7% and 63.3% respectively.Conclusion The decline rate of signal intensity and apparent diffusion coefficient with different b values may be used for differentiating benign and malignant breast lesions.And the diagnostic efficiency with b values of 400-800 s/mm2 is optimal.
