CAJ | 학술논문

目的：探讨不同表观扩散系数(ADC)值测量方法对乳腺良恶性病变的鉴别诊断价值。方法收集248例经病理证实的乳腺病变,采用4种 ADC值测量方法获得4组 ADC值,即局部测量 ADC均值(ADCmean )、局部测量 ADC最小值(ADCmin )、整体测量ADC均值(ADCW-mean )和整体测量 ADC最小值(ADCW-min ),运用 ROC曲线确定4组 ADC值对乳腺恶性病变的诊断临界值并分析其诊断效能。结果诊断乳腺恶性肿瘤效能最高的 ADCmean、ADCmin、ADCW-mean和 ADCW-min临界值分别为1.315×10-3 mm2/s、1.111×10-3 mm2/s、1.223×10-3 mm2/s、0.897×10-3 mm2/s,其鉴别乳腺良恶性病变的 ROC 曲线下面积(AUC)分别为0.919、0.928、0.940、0.969；ADCW-min与ADCW-mean、ADCW-min与ADCmin、ADCW-min与ADCmean、ADCW-mean与ADCmean间的AUC差异具有统计学意义。结论不同 ADC值测量方法对乳腺良恶性病变的鉴别诊断效能存在差异；ADCW-min对乳腺良恶性病变的鉴别诊断价值最大。
목적：탐토불동표관확산계수(ADC)치측량방법대유선량악성병변적감별진단개치。방법수집248례경병리증실적유선병변,채용4충 ADC치측량방법획득4조 ADC치,즉국부측량 ADC균치(ADCmean )、국부측량 ADC최소치(ADCmin )、정체측량ADC균치(ADCW-mean )화정체측량 ADC최소치(ADCW-min ),운용 ROC곡선학정4조 ADC치대유선악성병변적진단림계치병분석기진단효능。결과진단유선악성종류효능최고적 ADCmean、ADCmin、ADCW-mean화 ADCW-min림계치분별위1.315×10-3 mm2/s、1.111×10-3 mm2/s、1.223×10-3 mm2/s、0.897×10-3 mm2/s,기감별유선량악성병변적 ROC 곡선하면적(AUC)분별위0.919、0.928、0.940、0.969；ADCW-min여ADCW-mean、ADCW-min여ADCmin、ADCW-min여ADCmean、ADCW-mean여ADCmean간적AUC차이구유통계학의의。결론불동 ADC치측량방법대유선량악성병변적감별진단효능존재차이；ADCW-min대유선량악성병변적감별진단개치최대。
Objective To explore the diagnostic performance of apparent diffusion coefficient (ADC)values for breast lesions by different measuring methods.Methods Two hundred and forty-eight patients with breast lesions conformed by histopathology were included in this study.Four groups of ADCs (ADCmean ,ADCmin ,ADCW-mean and ADCW-min )were obtained by four measuring methods, that is,ADCW-mean and ADCW-min were obtained by whole-measurement method,while ADCmean and ADCmin were extracted by spot-measurement method.The thresholds of breast malignant lesions in four groups were accurately calculated by receiver operating characteristics (ROC)curve analysis and the diagnostic efficiency of ADCs was evaluated.Results The optimal diagnostic threshold of ADCmean,ADCmin,ADCW-mean and ADCW-min values were 1.315×10-3 mm2/s,1.111×10-3 mm2/s,1.223×10-3 mm2/s,0.897× 10-3 mm2/s respectively.Furthermore,the AUC values in the diagnosis of breast benign lesions were 0.919,0.928,0.940,0.969 re-spectively.The difference of the areas under ROC curve(ADC)between ADCW-min and ADCW-mean ,ADCW-min and ADCmin ,ADCW-min and ADCmean ,ADCW-mean and ADCmean had statistical significance.Conclusion Different measuring methods on ADCs show different levels of diagnostic efficiency in the differentiation of breast lesions.The results provided evidence that ADCW-min has the highest diag-nostic value in distinguishing breast lesions from malignant to benign.