Objective:To assess the diagnostic value of apparent diffusion coefficient (ADC)and relative-ADC (rADC)in the diagnosis of breast mass and non-mass-like lesion.Methods:The MRI and DWI data of 177 patients with pathologically confirmed breast lesions were retrospectively analyzed.ADC and rADC of benign and malignant lesions were measured and compared (t-test),and receiver operating characteristic curve (ROC)analysis was used to evaluate the diag-nostic performance of ADC and rADC in differentiating benign and malignant lesions.Results:Among 177 patients there were 112 benign and 65 malignant lesions;144 were mass-like and 33 were non-mass-like.Among 144 mass-like lesions,47 were malignant and 97 were benign.The mean ADC and rADC values of malignant lesions [(1.06±0.27)×10-3mm2/s, 0.62±0.17]were statistically lower than those of benign ones [(1.58±0.26)×10-3mm2/s,0.91±0.17].The sensitivity and specificity of the ADC and rADC for diagnosis of malignant lesions with thresholds of 1.23×10-3mm2/s and 0.72 were 85.1%、92.8% and 80.9%、89.7% respectively.Among 33 non-mass lesions 18 were malignant and 15 were benign.The mean ADC value of malignant lesions [(1.25 ±0.40)×10-3 mm2/s]was statistically lower than that of benign lesions [(1.50±0.18)×10-3mm2/s],while the mean rADC value of malignant lesions (0.76±0.25)was not statistically lower than that of benign lesions (0.89±0.12).The sensitivity and specificity of the ADC and rADC for diagnosis of malignant lesions with thresholds of 1.36×10-3mm2/s and 0.84 were 77.8%,80.0% and 77.8%,73.3% respectively.Conclusion:The ADC is an effective parameter in distinguishing between malignant and benign breast lesions.Cut-off values of ADCs are different between breast masses and lesions with nonmasslike enhancement.The study indicated that ADC value is more valuable in differentiation of benign and malignant breast lesions than rADC value.%目的：探讨ADC值及相对ADC值（rADC）对乳腺肿块样和非肿块样强化病变的诊断价值。方法：回顾性分析术经手术病理证实的171例乳腺病变患者（共177个病灶）的术前 MRI和DWI（b＝0和800s／mm2）资料，测量并比较（t检验）乳腺肿块和非肿块样良、恶性病变的ADC值及rADC值，采用受试者工作特征曲线（ROC）分析ADC值及rADC值在乳腺良、恶性病变定性诊断中的效能。结果：177个乳腺病变中良性病变112个，恶性病变65个；按病变形态分组，肿块性病变144个，非肿块性病变33个。肿块性病变中恶性47个，平均 ADC 值及平均 rADC 值分别为（1．06±0．27）×10－3mm2／s和0．62±0．17；良性97个，平均ADC 值及 rADC 值分别为（1．58±0．26）×10－3mm2／s 和0．91±0．17；ROC分析显示，以ADC值和rADC值分别为1．23×10－3mm2／s和0．72作为阈值，鉴别肿块样乳腺良、恶性病变的敏感度和特异度分别为85．1％、92．8％和80．9％、89．7％。33个非肿块性病变中恶性18个，平均ADC值及rADC值分别为（1．25±0．40）×10－3mm2／s 和0．76±0．25；良性15个，平均 ADC 值和 rADC 值分别为（1．50±0．18）×10－3mm2／s 和0．89±0．12；ROC分析显示，以ADC和rADC值分别为1．36×10－3mm2／s、0．84作为阈值，鉴别非肿块样乳腺良、恶性病变的敏感度和特异度分别为77．8％、80．0％和77．8％、73．3％。结论：根据ADC和rADC值可以鉴别乳腺良、恶性病变，ADC值的诊断价值略高于rADC值，对乳腺肿块性和非肿块性病变应采用不同的ADC。
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