中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2013年
1期
20-23
,共4页
刘伟%叶春涛%林光武%臧雪如%朱震方%嵇鸣
劉偉%葉春濤%林光武%臧雪如%硃震方%嵇鳴
류위%협춘도%림광무%장설여%주진방%혜명
乳腺肿瘤%磁共振成像%扩散加权成像%诊断,鉴别
乳腺腫瘤%磁共振成像%擴散加權成像%診斷,鑒彆
유선종류%자공진성상%확산가권성상%진단,감별
Breast neoplasms%Magnetic resonance imaging%Perfusion weighted image%Diagnosis, differential
目的探讨3.0T MR 扩散加权成像(DWI)在鉴别乳腺良恶性病变中的价值.资料与方法65例经穿刺活检或手术病理证实的乳腺病变患者行 MRI 及 DWI 检查, b 值取50、450、850 s/mm2.计算 DWI 的病灶检出率,比较不同 b 值时正常腺体组织、良性病变、恶性病变的表观扩散系数(ADC),以及肿块样病变和非肿块样病变的ADC 值.以恶性病变 ADC 值95%可信区间上限作为诊断阈值,计算不同 b 值的诊断敏感性、特异性、准确率、阳性预测值、阴性预测值.结果 DWI 对病灶的检出率为95.4%(62/65),包括32例恶性病灶和30例良性病灶;3例导管原位癌未显示.b=50~850 s/mm2时诊断敏感性、特异性、准确率、阳性预测值、阴性预测值分别为87.5%、83.3%、85.5%、84.8%、86.2%,高于 b=50~450 s/mm2时的84.4%、80.0%、82.3%、81.8%、82.8%.不同 b 值时正常腺体组织、良性病变、恶性病变之间 ADC值差异均有统计学意义(P<0.01).肿块样与非肿块样良恶性病变之间 ADC 值差异均有统计学意义(P<0.01).结论3.0T MR 扩散加权成像有助于良恶性病变的鉴别,但诊断时需结合常规 MR 扫描避免漏诊、误诊.
目的探討3.0T MR 擴散加權成像(DWI)在鑒彆乳腺良噁性病變中的價值.資料與方法65例經穿刺活檢或手術病理證實的乳腺病變患者行 MRI 及 DWI 檢查, b 值取50、450、850 s/mm2.計算 DWI 的病竈檢齣率,比較不同 b 值時正常腺體組織、良性病變、噁性病變的錶觀擴散繫數(ADC),以及腫塊樣病變和非腫塊樣病變的ADC 值.以噁性病變 ADC 值95%可信區間上限作為診斷閾值,計算不同 b 值的診斷敏感性、特異性、準確率、暘性預測值、陰性預測值.結果 DWI 對病竈的檢齣率為95.4%(62/65),包括32例噁性病竈和30例良性病竈;3例導管原位癌未顯示.b=50~850 s/mm2時診斷敏感性、特異性、準確率、暘性預測值、陰性預測值分彆為87.5%、83.3%、85.5%、84.8%、86.2%,高于 b=50~450 s/mm2時的84.4%、80.0%、82.3%、81.8%、82.8%.不同 b 值時正常腺體組織、良性病變、噁性病變之間 ADC值差異均有統計學意義(P<0.01).腫塊樣與非腫塊樣良噁性病變之間 ADC 值差異均有統計學意義(P<0.01).結論3.0T MR 擴散加權成像有助于良噁性病變的鑒彆,但診斷時需結閤常規 MR 掃描避免漏診、誤診.
목적탐토3.0T MR 확산가권성상(DWI)재감별유선량악성병변중적개치.자료여방법65례경천자활검혹수술병리증실적유선병변환자행 MRI 급 DWI 검사, b 치취50、450、850 s/mm2.계산 DWI 적병조검출솔,비교불동 b 치시정상선체조직、량성병변、악성병변적표관확산계수(ADC),이급종괴양병변화비종괴양병변적ADC 치.이악성병변 ADC 치95%가신구간상한작위진단역치,계산불동 b 치적진단민감성、특이성、준학솔、양성예측치、음성예측치.결과 DWI 대병조적검출솔위95.4%(62/65),포괄32례악성병조화30례량성병조;3례도관원위암미현시.b=50~850 s/mm2시진단민감성、특이성、준학솔、양성예측치、음성예측치분별위87.5%、83.3%、85.5%、84.8%、86.2%,고우 b=50~450 s/mm2시적84.4%、80.0%、82.3%、81.8%、82.8%.불동 b 치시정상선체조직、량성병변、악성병변지간 ADC치차이균유통계학의의(P<0.01).종괴양여비종괴양량악성병변지간 ADC 치차이균유통계학의의(P<0.01).결론3.0T MR 확산가권성상유조우량악성병변적감별,단진단시수결합상규 MR 소묘피면루진、오진.
Purpose To investigate the diagnostic value of diffusion weighted imaging (DWI) at 3.0T in differentiating benign and malignant breast lesions. Materials and Methods Sixty-five cases of biopsy or surgical pathology proved breast lesions were underwent MRI and DWI examination, and b values were taken as 50, 450 and 850 s/mm2, respectively. Lesion detection rate of DWI was calculated, and apparent diffusion coefficient (ADC) value was compared among normal glandular tissue, benign lesions, malignant lesions using different b values, and between the mass lesions and the non-mass lesion. Taken 95% confidence interval limit of ADC in malignant lesions as a diagnostic threshold value, the diagnostic sensitivity, specificity and accuracy, positive predictive value and negative predictive value of different b value were calculated. Results Lesion detection rate of DWI was 95.4% (62/65), including 32 patients with malignant lesions and 30 cases of benign lesions; 3 cases of ductal carcinoma in situ were not shown. Diagnostic sensitivity, specificity and accuracy, positive predictive value and negative predictive value were 87.5%, 83.3%, 85.5%, 84.8%, 86.2% when b value was 50-850 s/mm2, higher than 84.4%, 80.0%, 82.3%, 81.8%, 82.8% when b value was 50-450 s/mm2. ADC value was demonstrated significant difference among normal glandular tissue, benign lesions and malignant lesions in different b value (P<0.01). ADC value also showed obvious difference between mass lesions and the non-mass lesions and between the benign and malignant lesions (P<0.01). Conclusion DWI at 3.0T is help to identify benign and malignant lesions, but the diagnosis should be combined with conventional MR imaging to avoid missing diagnosis and misdiagnosis.
