CAJ | 학술논문

目的：评价在磁共振(MR)扩散加权成像(DWI)中,2种感兴趣(ROI)选取方法对乳腺病变表观扩散系数(ADC)测量值的影响。方法选择因乳腺包块进行术前乳腺MR平扫、DWI扫描和MR动态增强扫描的53例患者,由2名医师在不知道组织病理检查结果的情况下,分别采用固定 ROI(10 mm2±2 mm2)方法和常规 ROI方法测量乳腺病灶的 ADC值并进行统计学比较,同时采用受试者工作特征(ROC)曲线分析2种方法测量所得的 ADC值对乳腺癌诊断的价值。结果53例乳腺疾病患者中共有62个病灶,恶性病灶33个,良性病灶29个。医师1用固定 ROI方法测得良性病灶 ADC平均值为(1.647±0.359)×10-3 mm2/s,恶性病灶 ADC平均值为(1.136±0.227)×10-3 mm2/s,ADC值诊断乳腺癌的 ROC曲线下面积为0.897；其采用常规 ROI方法测量的值依次为(1.603±0.415)×10-3 mm2/s,(1.251±0.237)×10-3 mm2/s 和0.768。医师2用固定 ROI 方法测得 ADC 平均值为(1.647±0.357)×10-3 mm2/s 和(1.130±0.250)×10-3 mm2/s,用常规 ROI 方法测得的 ADC 平均值为(1.590±0.390)×10-3 mm2/s和(1.250±0.237)×10-3 mm2/s。对于良性病灶,2种方法测得的 ADC平均值差异无统计学意义(P=0.528),对于恶性病灶,其差异有统计学意义(P=0.002),显示固定 ROI方法对于乳腺疾病的诊断价值优于常规 ROI方法(P=0.008)。2名医师分别用2种方法测量的良、恶性病灶的 ADC平均值差异均无统计学意义(P均>0.05)。结论 DWI可提高乳腺疾病的良、恶性鉴别诊断效能,固定 ROI方法测量 ADC平均值优于常规 ROI方法,更能体现恶性病灶的特征。
목적：평개재자공진(MR)확산가권성상(DWI)중,2충감흥취(ROI)선취방법대유선병변표관확산계수(ADC)측량치적영향。방법선택인유선포괴진행술전유선MR평소、DWI소묘화MR동태증강소묘적53례환자,유2명의사재불지도조직병리검사결과적정황하,분별채용고정 ROI(10 mm2±2 mm2)방법화상규 ROI방법측량유선병조적 ADC치병진행통계학비교,동시채용수시자공작특정(ROC)곡선분석2충방법측량소득적 ADC치대유선암진단적개치。결과53례유선질병환자중공유62개병조,악성병조33개,량성병조29개。의사1용고정 ROI방법측득량성병조 ADC평균치위(1.647±0.359)×10-3 mm2/s,악성병조 ADC평균치위(1.136±0.227)×10-3 mm2/s,ADC치진단유선암적 ROC곡선하면적위0.897；기채용상규 ROI방법측량적치의차위(1.603±0.415)×10-3 mm2/s,(1.251±0.237)×10-3 mm2/s 화0.768。의사2용고정 ROI 방법측득 ADC 평균치위(1.647±0.357)×10-3 mm2/s 화(1.130±0.250)×10-3 mm2/s,용상규 ROI 방법측득적 ADC 평균치위(1.590±0.390)×10-3 mm2/s화(1.250±0.237)×10-3 mm2/s。대우량성병조,2충방법측득적 ADC평균치차이무통계학의의(P=0.528),대우악성병조,기차이유통계학의의(P=0.002),현시고정 ROI방법대우유선질병적진단개치우우상규 ROI방법(P=0.008)。2명의사분별용2충방법측량적량、악성병조적 ADC평균치차이균무통계학의의(P균>0.05)。결론 DWI가제고유선질병적량、악성감별진단효능,고정 ROI방법측량 ADC평균치우우상규 ROI방법,경능체현악성병조적특정。
Objective To evaluate two methods of selecting region of interest (ROI)to measure the apparent diffusion coefficient (ADC)of breast lesions on diffusion-weighted imaging (DWI).Methods MRI findings (including plain MRI,dynamic contrast-en-hanced MRI and DWI)of 5 3 cases with breast mass confirmed by pathology were analyzed retrospectively.Two observers independ-ently measured the ADC of breast lesions by the method of fixed ROI with the size of 10 mm2 ±2 mm2 and the routine method.The mean ADCs of benign and malignant breast lesions were compared between two methods and two observers by using paired samples T-test.The values of ADC diagnosing breast cancer were compared between the two methods by using the receiver operating charac-teristic (ROC)curve.Results Among 62 lesions of 53 cases,33 lesions were malignant,and 29 lesions were benign.For the first observer,the mean ADCs of benign and malignant lesions were (1.647±0.359)×10-3 mm2/s and (1.136±0.227)×10-3 mm2/s measured by the fixed ROI method,respectively.The area under the ROC was 0.897.The mean ADCs of benign and malignant le-sions were (1.603±0.415)×10-3mm2/s and (1.251±0.237)×10-3 mm2/s measured by the routine method,respectively.The area under the ROC was 0.768.For another observer,the mean ADCs of benign and malignant lesions were (1.647±0.357)× 10-3 mm2/s and (1.130±0.250)×10-3 mm2/s measured by the fixed ROI method,respectively.The mean ADCs of benign and malignant lesions were (1.590± 0.390)×10-3 mm2/s and (1.250±0.237)×10-3 mm2/s measured by the routine method,respec-tively.There was no significant difference for the mean ADC of benign lesions between the two methods.However,there was sig-nificant difference for the mean ADC of malignant lesions between the two methods.The diagnostic value of ADC measured by the fixing method was better than that of the routine method (P=0.008).There were no significant differences for ADCs of benign and malignant lesions between the two observers.Conclusion DWI has an important value for differential diagnosis of benign and malignant breast lesions.The measurement of ADC by the fixed and smaller ROI is better than that by the routine ROI for dis-tinguishing malignant from benign breast lesions.