不同b值MR扩散加权成像对乳腺良恶性肿瘤鉴别诊断价值研究

摘要

Objective:To explore the value of multi-b value MR Diffusion Weighted Imaging (DWI) and ADC (apparent diffusion coefifcient) in differentiation of breast benign and malignant tumors. Materials and Methods: Thirty-six cases of breast tumors including 24 malignant and 12 benign tumors were collected, all of which were conifrmed by biopsy or surgery pathology. All of 4 b values (0, 400, 800, 1000 s/mm2) were performed on DWI examination, and 3 groups of ADC value were generated. Results:The ADC value of malignant tumors was lower than that of benign tumors. There exists statistic signiifcance of ADC value between benign and malignant breast tumors in different b value. The sensitivity and specificity of ADC was 84.7% and 79.8% when b=800 s/mm2 and set 1.33×10-3 mm2/s as the upper bound. And the sensitivity and specificity of ADC was 92.2% and 90.6% when b=1000 s/mm2 and set 1.15×10-3 mm2/s as the upper bound. Conclusions: DWI has great value in the differentiation of breast benign and malignant tumors, and it has most diagnostic accuracy when b was set 1000 s/mm2.%目的：探讨不同b值MR扩散加权成像(diffusion weighted imaging，DWI)及ADC (apparent diffusion coefficient)值对乳腺良恶性肿瘤的鉴别诊断价值。材料与方法搜集乳腺肿瘤患者共36例，其中恶性24例，良性12例，均经穿刺或手术病理证实。乳腺DWI成像采用4个b值(分别为0、400、800和1000 s/mm2)，分别计算乳腺良恶性肿瘤不同b值条件下共3组ADC值。结果乳腺恶性肿瘤ADC值均低于良性者，乳腺良恶性肿瘤不同b值条件下ADC值均有统计学差异。当b=800 s/mm2时，取ADC值为1.33×10－3 mm2/s为良恶性肿瘤的界定值，诊断的敏感性和特异性分别为84.7%和79.8%。当b=1000 s/mm2时，以ADC值为1.15×10－3 mm2/s为良恶性肿瘤的界定值，诊断的敏感性和特异性分别为92.2%和90.6%。结论 DWI对乳腺良恶性肿瘤的诊断具有重要价值，b值为1000s/mm2时具有较高的诊断准确性。