CAJ | 학술논문

目的探讨3.0 T MR扩散加权成像在不同b值条件下乳腺病灶信噪比及信号强度比的变化规律.方法回顾性分析经手术病理证实的97例乳腺良恶性非囊性疾病患者资料,共有106个病灶,其中恶性病灶44个、良性病灶62个.患者术前均行3.0 T MR DWI检查,b值分别采用0、400、800、1 000 s/mm2.对图像质量进行分级,并观察测量不同b值下病灶的信噪比(SNR)及良、恶性病灶的信号强度比(SIR).定量资料比较采用t检验及单因素方差分析比较,ROC曲线分析不同b值下SIR的诊断效能.结果不同b值条件下,甲级图像均92例,乙级图像均5例,无影响诊断的丙级图像.b值为0、400、800、1 000 s/mm2时,良性病灶的SIR分别为2.33±1.36、2.25±1.13、2.06±0.84、2.02±0.79,恶性病灶的SIR分别为2.02±0.79、2.27±0.85、2.61 ±0.78、2.82±1.01.b值为0、400 s/mm2时,良、恶性病灶间的SIR差异无统计学意义(t值分别为1.58、1.26,P值分别为0.12、0.90)；b值为800、1 000 s/mm2时,差异有统计学意义(t值分别为3.41、4.29,P值均＜0.01)；不同b值时,良、恶性病灶SIR间差异均无统计学意义(F值分别为1.21、2.22,P值均＞0.05).b值为0、400、800、1 000 s/mm2时,SIR对乳腺良恶性病变诊断的敏感度分别为56.8％(25/44)、56.8％(25/44)、75.0％ (33/44)、77.3％ (34/44),特异度分别为51.6％(32/62)、54.8％(34/62)、66.1％(41/62)、66.1％(41/62).b值为0、400、800、1 000 s/mm2时,SNR分别为170±93、145 ±72、84±41和70±39,差异有统计学意义(F值=55.89,P值＜0.01),两两比较差异也均有统计学意义(P值均＜0.05).结论 3.0T MR采用较高b值(800、1 000 s/mm2)时对乳腺良、恶性病变具有鉴别诊断价值.
목적 탐토3.0 T MR확산가권성상재불동b치조건하유선병조신조비급신호강도비적변화규률.방법 회고성분석경수술병리증실적97례유선량악성비낭성질병환자자료,공유106개병조,기중악성병조44개、량성병조62개.환자술전균행3.0 T MR DWI검사,b치분별채용0、400、800、1 000 s/mm2.대도상질량진행분급,병관찰측량불동b치하병조적신조비(SNR)급량、악성병조적신호강도비(SIR).정량자료비교채용t검험급단인소방차분석비교,ROC곡선분석불동b치하SIR적진단효능.결과 불동b치조건하,갑급도상균92례,을급도상균5례,무영향진단적병급도상.b치위0、400、800、1 000 s/mm2시,량성병조적SIR분별위2.33±1.36、2.25±1.13、2.06±0.84、2.02±0.79,악성병조적SIR분별위2.02±0.79、2.27±0.85、2.61 ±0.78、2.82±1.01.b치위0、400 s/mm2시,량、악성병조간적SIR차이무통계학의의(t치분별위1.58、1.26,P치분별위0.12、0.90)；b치위800、1 000 s/mm2시,차이유통계학의의(t치분별위3.41、4.29,P치균＜0.01)；불동b치시,량、악성병조SIR간차이균무통계학의의(F치분별위1.21、2.22,P치균＞0.05).b치위0、400、800、1 000 s/mm2시,SIR대유선량악성병변진단적민감도분별위56.8％(25/44)、56.8％(25/44)、75.0％ (33/44)、77.3％ (34/44),특이도분별위51.6％(32/62)、54.8％(34/62)、66.1％(41/62)、66.1％(41/62).b치위0、400、800、1 000 s/mm2시,SNR분별위170±93、145 ±72、84±41화70±39,차이유통계학의의(F치=55.89,P치＜0.01),량량비교차이야균유통계학의의(P치균＜0.05).결론 3.0T MR채용교고b치(800、1 000 s/mm2)시대유선량、악성병변구유감별진단개치.
Objective To investigate the signal intensity ratio and signal-to-noise ratio of breast lesions in 3.0 T MR diffusion weighted imaging with different b values.Methods Ninety seven patients with 106 solid breast lesions (44 malignant,62 benign) confirmed by pathology were retrospectively analyzed.The patients were examined by 3.0 T MR DWI with different b values (b =0,400,800,1 000 s/mm2) before surgery.The signal-to-noise ratio (SNR) and signal intensity ratio (SIR) of benign and malignant lesions were observed and measured under different b values.One-way ANOVA and t test were used to analyze quantitative data.ROC curve was used to analyze the diagnostic efficiency of SIR under different b values.Results Under different b values,class A image was found in 92 cases,class B images was found in 5 cases.While b value were 0,400,800,1 000 s/mm2,SIR of benign lesions were 2.33 ± 1.36,2.25 ± 1.13,2.06 ± 0.84,2.02 ± 0.79 respectively,SIR of malignant lesions were 2.02 ± 0.79,2.27 ± 0.85,2.61±0.78,2.82 ± 1.01 respectively.While b value was 0 or 400 s/mm2,there was no significant differences for SIR between benign and malignant lesions (t value were 1.58,1.26 respectively; P value were 0.12,0.90 respectively),but there were statistically significances between benign and malignant lesions under b value 800 s/mm2 or 1 000 s/mm2 (t value were 3.41,4.29 respectively ;P ＜0.01).There was no differences in SIR for benign and malignant lesions under different b values respectively (F value is 1.21,2.22 respectively; P ＞0.05).While b value were 0,400,800,1 000 s/mm2,the diagnostic sensitivity and specificity of SIR for breast benign and malignant lesions were 56.8％ (25/44),56.8％ (25/44),75.0％ (33/44),77.3％ (34/44) and 51.6％ (32/62),54.8％ (34/62),66.1％ (41/62),66.1％ (41/62) respectively.While b value were 0,400,800,1 000 s/mm2,SNR were 170 ±93,145 ±72,84 ±41,70 ± 39 respectively.Different b values,there was statistically significant difference between groups (F =55.89,P ＜ 0.01) ; and there were significant differences between every two b values (P ＜ 0.05).Conclusion The higher b values (800 s/mm2 and 1 000 s/mm2) are superior to lower b values in the differential diagnosis of benign and malignant breast lesions using 3.0 T MR scanner.