CAJ | 학술논문

目的评价表观扩散系数(ADC)在乳腺良性病变、恶性病变以及炎性病变中的鉴别诊断的价值.方法收集女性乳腺疾病患者63例,另选取13名健康女性志愿者作为对照组,全部行MRI常规成像、扩散加权成像(DWI)检查,扩散敏感系数b值取0、500、1,000s/mm2.观察分析病变在MRI常规平扫、DWI图像的信号特征,测量不同b值感兴趣区(ROI)的ADC值.乳腺良性病变、恶性病变、炎性病变、正常对照组之间的ADC值的比较,采用单因素方差分析统计分析.并绘制ROC曲线检验诊断效能.计算不同阈值下,ADC值诊断的敏感性、特异性、准确性,并与形态学评价相结合,确定合适的b值和阈值.结果按照恶性病变、良性病变、炎性病变及正常腺体分为四类,b=500、1,000s/mm2时,恶性病变、炎性病变平均ADC值之间均无统计学差异,而其余各组平均ADC值两两之间均有明显统计学差异.同一b值下,乳腺恶性病变、炎性病变较良性病变和正常腺体明显低,而良性病变平均ADC值较正常腺体低.通过受试者工作特征曲线,确定不同b值下诊断乳腺良、恶性病变的ADC阈值,并计算其诊断敏感度、特异性、正确率.结论乳腺恶性病变和炎性病变的ADC值无明显统计学差异.b=500s/mm2阈值为1.202×10-3mm2/s;b=1,000s/mm2阈值为1.117×10-3mm2/s,ADC值的分析对乳腺良性(不包括炎性病变)、恶性病变的诊断有较高的价值.
목적평개표관확산계수(ADC)재유선량성병변、악성병변이급염성병변중적감별진단적개치.방법수집녀성유선질병환자63례,령선취13명건강녀성지원자작위대조조,전부행MRI상규성상、확산가권성상(DWI)검사,확산민감계수b치취0、500、1,000s/mm2.관찰분석병변재MRI상규평소、DWI도상적신호특정,측량불동b치감흥취구(ROI)적ADC치.유선량성병변、악성병변、염성병변、정상대조조지간적ADC치적비교,채용단인소방차분석통계분석.병회제ROC곡선검험진단효능.계산불동역치하,ADC치진단적민감성、특이성、준학성,병여형태학평개상결합,학정합괄적b치화역치.결과안조악성병변、량성병변、염성병변급정상선체분위사류,b=500、1,000s/mm2시,악성병변、염성병변평균ADC치지간균무통계학차이,이기여각조평균ADC치량량지간균유명현통계학차이.동일b치하,유선악성병변、염성병변교량성병변화정상선체명현저,이량성병변평균ADC치교정상선체저.통과수시자공작특정곡선,학정불동b치하진단유선량、악성병변적ADC역치,병계산기진단민감도、특이성、정학솔.결론유선악성병변화염성병변적ADC치무명현통계학차이.b=500s/mm2역치위1.202×10-3mm2/s;b=1,000s/mm2역치위1.117×10-3mm2/s,ADC치적분석대유선량성(불포괄염성병변)、악성병변적진단유교고적개치.
Objective To evaluate ADC in differential diagnosis of benign,malignant and inflammatory breast lesions.Methods 63 female patients with breast disease and 13 healthy females,selected as a control group,were included in our study.All subjects were tested with conventional imaging of magnetic resonance imagery(MRI),and diffusion-weighted imaging(DWI),with diffusion-sensitive coefficients(b-value) being set at 0,500,1,000s/mm2.The signal characteristics of the lesions observed in a conventional MRI scan and DWI image were analyzed.The ADC values of regions of interest(ROI) were measured at different b-values.The ADC values among benign,malignant breast lesions and inflammatory lesions,and among normal controls were compared using one-way ANOVA.Receiver operating characteristic(ROC) curves were drawn to evaluate the diagnostic performance.The diagnostic sensitivity,specificity,and accuracy of ADC values were evaluated under different thresholds,which were combined with morphological evaluations,in order to determine appropriate b-value and threshold.Results Malignant,benign and inflammatory lesions and normal glands were divided into four categories.Using b=500 and 1,000s/mm2,there were no statistical differences in mean ADC values between malignant and inflammatory lesions,while the statistical differences were seen between the other groups.When comparing each group individually they all showed significant statistical difference.The mean ADC values in malignant and benign lesions were lower than that in normal gland tissue with the same b-value.The ADC threshold was determined to diagnose benign and malignant breast lesions under different b-values with ROC curves.The diagnostic sensitivity,specificity,and accuracy of the ADC threshold were valuated.Conclusion There was no significant difference in ADC values between malignant and inflammatory breast lesions,when using b=500s/mm2,threshold=1.202×10-3mm2/s or when using b=1,000s/mm2,threshold=1.117×10-3mm2/s.ADC values were of most significance for differentiating benign(excluding inflammatory lesions) from malignant breast lesions.