DCE－MRI 及 DWI 在鉴别乳腺良、恶性病变中的价值

摘要

目的：探讨动态增强 MRI（DCE－MRI）及扩散加权成像（DWI）在乳腺良、恶性病变鉴别诊断中的价值。方法：对85例乳腺病变患者行乳腺 MRI 动态增强及 DWI 扫描，经后处理获得：时间－信号强度（TIC）曲线类型、达峰时间（Tmax）、早期强化率（EER）、峰值强化率（PER）、信号增强比（SER）、峰值（SImax）及表观扩散系数（ADC）。结果：良性病变62个，恶性病变34个，良性病变的 Tmax、PER、SImax、ADC 值显著高于恶性病变（P ＜0．05），良性病变的 SER 显著低于恶性病变（P ＜0．05），良、恶性病变 EER 差异无统计学意义（P ＝0．869）；良性病变以Ⅰ型曲线为主（45／62），恶性病变以Ⅱ型和Ⅲ型曲线为主（27／34），TIC 曲线类型在良、恶性病变中差异有统计学意义（P ＜0．05）；ADC 鉴别乳腺良、恶性病变的诊断效能最高（AUC ＝0．898）。结论：DCE－MRI 及 DWI 对鉴别乳腺病变的良、恶性病变有重要价值。%Aim: To investigate the differential diagnostic value of dynamic contrast -enhanced MRI(DCE-MRI) and diffusion weighed imaging (DWI) in benign and malignant breast lesions .Methods:A total of 85 patients with breast tumors underwent DCE-MRI and DWI,the value of ADC and semi-quantitative parameters including TIC type ,Tmax,EER, PER,SER,SImax were measured at a workstation .Differences in these parameters between the benign and malignant groups were compared.Results: There were 62 benign and 34 malignant tumors.The Tmax,PER,SImax,and ADC values of be-nign tumors were significantly higher than malignant tumors (P <0.05),while the SER value of benign tumors were signifi -cantly lower than malignant tumors (P <0.05).There was no statistical difference in EER between benign tumors and ma -lignant tumors(P =0.869).The TIC curves of benign tumors were mostly type Ⅰ(41 /62),and the TIC curves of malignant tumors were mostly typeⅡand typeⅢ(27 /34).The ADC value had the highest diagnostic efficiency (AUC =0.898).Con-clusion: DCE-MRI combined with DWI are of significant value in the differential diagnosis of breast lesions .