Diffusion-weighted MRI of the breast: lesion characterization and parameter selection
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 5
- DOI:
- 10.3760/j.issn:1005-1201.2007.05.002
- Key Word:
- 乳腺肿瘤;磁共振成像;扩散
Abstract： 目的 探讨MR扩散加权成像(DWI)不同扩散敏感因子(b)值对鉴别乳腺良恶性病变的价值.方法 测定83例患者95个乳腺病变在b值分别取500、1000、2000 s/mm2时的表观扩散系数(ADC)值和信号强度,以手术后病理结果为金标准,比较同一b值时不同乳腺病变、以及不同b值时同一种病变平均ADC值和信号强度的差异.结果 (1)乳腺病变分为乳腺癌、良性病变和囊肿.各种病变的平均ADC值、平均信号强度在不同b值时不同,其中乳腺癌在b=500 s/mm2时分别为1.375±0.378和839.713±360.493(与其他病变比较,F值分别为16.019、30.409,P均＜0.01);b=1000 s/mm2时分别为1.176±0.311和459.314±229.609(与其他病变比较,F值分别为16.578和23.092,P均＜0.01);b=2000 s/mm2时分别为0.824±0.198和243.825±110.616(与其他病变比较,F值分别为3.122、23.888,P值分别＜0.05和＜0.01).各种乳腺病变两两比较显示在b=500和1000 s/mm2时,大部分病变之间平均ADC值差异有统计学意义,而在b=2000 s/mm2时仅在乳腺癌和良性病变间差异有统计学意义.(2)以各b值时乳腺癌平均ADC 95%可信区间的上限作为确定乳腺癌的上限阈值点,取这些阈值点在b值=500、1000、2000 s/mm2时确定乳腺癌的诊断指标,敏感性分别为70.92%、70.73%、69.77%,特异性分别为77.19%、75.70%、54.76%,准确性分别为77.12%、74.32%、62.35%.ROC曲线分析曲线下面积(Az)500=0.775±0.046,Az1000=0.780±0.044,P均＜0.01,提示b取500和1000 s/mm2时对诊断乳腺癌有统计学意义.而Az2000=0.620±0.062,P＞0.05,提示b=2000 s/mm2对鉴别乳腺良恶性病变差异无统计学意义.结论 b值取500和1000 s/mm2的MR DWI可以用于鉴别乳腺良恶性病变.
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