多b值扩散加权成像联合动态增强时间-信号强度曲线在乳腺良恶性病变鉴别诊断中的价值

摘要

Objective To explore the clinical application value of multi-b-value diffusion weighted imaging (mb-dwi) combining dynamic enhanced time-signal strength curve (TIC) in the differential diagnosis of benign and malignant breast lesions.Methods 236 patients taking breast MRI examination at our hospital from May 2016 to April 2017 were selected.Among which,95 had malignant lesions and 141 benign.And 40 healthy volunteers were selected as a control group.All the three groups took MB-DWI examination;and TIC dispersion curve was drawn and post-processing was taken.The model parameters (ADC value),ADCstandard,and TIC curve type of the three groups of diffuse weighted imaging (ADC) were observed.Results The ADC value and ADCstandard value were lower in the malignant lesion group than in the benign lesion group and the control group,with statistical differences (all P ＜ 0.05).The proportion of type I TIC curve was much lower in the malignant lesion group than in the benign lesion group and the control group,with statistical differences (P ＜ 0.001);the proportion of type Ⅲ TIC curve was much higher in the malignant lesion group than in the benign lesion group and the control group,with statistical differences (P ＜ 0.05).Conclusion WB-DWI combined TIC curve can be used to diagnose benign and malignant lesions of mammary gland and has higher diagnostic value than only one indicator.%目的 探讨多b值扩散加权成像(MB-DWI)联合动态增强时间-信号强度曲线(TIC)对乳腺良恶性病变诊断的临床应用价值.方法 选取本院2016年5月至2017年4月期间行乳腺磁共振检查的患者236例,其中恶性病变患者95例、良性病变患者141例,同时另选取健康志愿者40例作为对照组,三组均进行MB-DWI检查,绘制TIC曲线进行弥散后处理.观察三组扩散加权成像单指数模型参数(ADC值)、体素内不相干运动模型参数值(ADCstandard)以及TIC曲线类型.结果 恶性病变组的ADC值和ADCstandard值均低于良性病变组和对照组,差异有统计学意义(P＜0.05);TIC曲线类型恶性病变组I型所占比例远低于良性病变组和对照组,差异有统计学意义(P＜0.001);Ⅲ型所占比例高于良性病变组和对照组,差异有统计学意义(P＜0.05).结论 WB-DWI联合TIC曲线能够协助诊断乳腺良恶性病灶,较单一指标单独应用具有更大的诊断价值.