CAJ | 학술논문

目的：探讨 MRI动态增强(DCE)与扩散加权成像(DWI)对乳腺病变的最佳联合诊断方法。方法67例患者均行常规MRI平扫、DCE及DWI检查,所有病例均经手术或穿刺活检证实。DCE扫描以 Fischer评分表及 BI-RADS分级判断良恶性；DWI检查通过受试者工作特征曲线(ROC曲线)分析确定最佳界值为判断良恶性的阈值。分别计算并比较 DCE、DWI 的独立诊断效能及二者不同联合方法的诊断效能,联合方法包括DCE为主DWI为辅法、优化组合法。结果表观扩散系数(ADC值)的最佳诊断界值为1.1×10-3 mm2/s,DWI诊断的敏感性、特异性、准确性分别为71.4%、88.6%、80%,DCE(Fischer 评分法)分别为100%、80%、90%,DCE为主DWI为辅法分别为85.7%、94.3%、90%,优化组合法均为91.4%。结论应用 DWI可提高乳腺病变 MRI诊断的特异性,但敏感性降低,容易造成病变的漏诊,只能作为辅助检查方法增加DCE诊断的信心。
목적：탐토 MRI동태증강(DCE)여확산가권성상(DWI)대유선병변적최가연합진단방법。방법67례환자균행상규MRI평소、DCE급DWI검사,소유병례균경수술혹천자활검증실。DCE소묘이 Fischer평분표급 BI-RADS분급판단량악성；DWI검사통과수시자공작특정곡선(ROC곡선)분석학정최가계치위판단량악성적역치。분별계산병비교 DCE、DWI 적독립진단효능급이자불동연합방법적진단효능,연합방법포괄DCE위주DWI위보법、우화조합법。결과표관확산계수(ADC치)적최가진단계치위1.1×10-3 mm2/s,DWI진단적민감성、특이성、준학성분별위71.4%、88.6%、80%,DCE(Fischer 평분법)분별위100%、80%、90%,DCE위주DWI위보법분별위85.7%、94.3%、90%,우화조합법균위91.4%。결론응용 DWI가제고유선병변 MRI진단적특이성,단민감성강저,용역조성병변적루진,지능작위보조검사방법증가DCE진단적신심。
Objective To explore the combination of dynamic contrast enhancement and diffusion weighted imaging in the diagno-sis of breast diseases.Methods 67 patients with breast mass proven by operation or biopsy underwent dynamic contrast enhance-ment and diffusion weighted imaging.Fischer scoring system and BI-RADS were used to distinguish the benign lesions from the ma-lignant mass.The optimal boundary value of ROC curve was set as the threshold in DWI.The independent and conj unctive diagnos-tic efficacy of DCE and DWI were calculated and compared.The conj unctive methods included combinated properly method and DCE used as the chief diagnostic method while DWI as the adj unctive method.Results the best diagnostic boundary of ADC values was 1.1×10-3 mm2/s,The sensitivity,specificity and diagnostic accuracy of DWI and DCE were 71.4%,88.6%,80% and 100%, 80%,90%,respectively.The value was 85.7%,94.3%,90%,when using DCE chiefly and DWI adjunctively,while it was 91.4%respectively in combinating properly method.Conclusion DWI can improve the specificity of MRI in diagnosing breast lesions while it can reduce the sensitivity,which can results in the missed diagnosis of malignant diseases.DWI can used as an auxiliary examina-tion method to increase the diagnostic confidence of DCE method.