摘要
目的:探讨MR扩散加权成像(DWI)对乳腺癌的诊断价值。方法:38个乳腺癌,24个乳腺良性病变及20个正常乳腺进行DWI检查。以病理结果为金标准,比较平均表观扩散系数(ADC)值的差异性,分析平均ADC值与乳腺良恶性病变的相关性,同时利用描绘受试者工作特征(ROC)曲线评价DWI预测乳腺癌的效能。结果:正常乳腺、乳腺良性病变、乳腺癌的平均ADC值分别为(1.882±0.119)、(1.307±0.196)、(0.941±0.164)×10-3mm2/s,差异有统计学意义(F=213.5,P<0.01)。浸润性导管癌的平均ADC值低于导管原位癌(U=60.0,P<0.05),同时平均ADC值与乳腺良恶性病变呈负性相关(r=-0.715,P<0.01)。利用平均ADC值预测乳腺癌时,ROC曲线下面积(Az)值为0.924,最佳临界点为1.065×10-3mm2/s,此时诊断的敏感性为78.95%(30/38),特异性为87.50%(21/24),准确性为85.48%(53/62),阳性预测值为90.90%(30/33),阴性预测值72.41%(21/29)。结论:DWI量化分析有助于乳腺癌的诊断及病理分型。
Objective To evaluate the value of diffusion-weighted imaging （DWI） for the differential diagnosis of breast cancer. Methods 38 patients with breast cancer and 24 with breast benign lesions confirmed by histopathology, and 20 normal controls were enrolled. The apparent diffusion coefficient （ADC） values were calculated and compared among them. The correlation between mean ADC values and the quality of breast lesions were analyzed, and ROC curve was drawn to determine the predictive effect of DWI for breast cancer. Results The ADC values were （1.882 ± 0.119）×10^-3 mm2/s, （ 1.307 ± 0.196）×10^-3 mm2/s, and （0.941 ± 0.164）×10^-3 mmVs in normal breast, benign breast lesions, and breast cancer （F = 213.5, P 〈 0.01 ）. The mean ADC values of the invasive ductal carcinoma were significantly lower than those of the ductal carcinomas in situ （U = 60.0, P 〈 0.05）. In addition, the mean ADC values were negatively correlated with the quality of breast lesions （r = -0.715, P 〈0.01）. According to the ROC analysis, the optimal operating point was determined at 1.065 x 10-3 mmVs for predicting breast cancer, and the area under curve was 0.924. The sensitivity, specificity, accuracy, positive predicting value and negative predictive value were 78.95% （30/38）, 87.50% （21/24）, 85.48% （53/62） , 90.90% （30/33）, and 72.41% （21/39） respectively. Conclusion The ADC value in DWI is useful for the differential diagnosis of breast cancer.
出处
《实用医学杂志》
CAS
北大核心
2010年第8期1342-1345,共4页
The Journal of Practical Medicine
基金
无锡市科技发展指导性计划项目(编号:CSZ00923)
关键词
乳腺肿瘤
扩散
量化
Breast Neoplasms
Diffusion-weighted
Quantitative
