摘要
目的 探讨3.0T磁共振成像（3.0T MRI）在乳腺良恶性病变中的诊断价值。方法 66例患者共70个病灶纳入研究,同时期行乳腺MRI检查的女性健康体检者30例设为对照。采用3.0T磁共振弥散加权成像（MRI-DWI）行乳腺扫描,扩散敏感因子（b值）取50、450、850 s/mm2。观察病灶检出率及DWI影像表现。以病理诊断为金标准,计算诊断乳腺癌的敏感度、特异度、阳性预测值及阴性预测值。根据病理检查结果,将患者分为恶性病变组、良性病变组,以及健康对照组,观察不同b值下3组表观弥散系数（ADC）值差异。结果 病灶检出率为94.29%（66/70）,其中恶性病变46例,良性病变20例。b=50~850 s/mm2时,得ADC阈值为1.087×10-3mm2/s,诊断出假阳性6例,假阴性5例;b=50~450 s/mm2时,得ADC阈值为1.236×10-3mm2/s,诊断出假阳性9例,假阴性7例。b=50~850 s/mm2时对恶性肿瘤诊断的敏感性、特异性、阳性预测值均高于b=50~450 s/mm2,阴性预测值低于前者。不同b值时,恶性病变的ADC值低于良性病变,良恶性病变组ADC值均低于健康对照组,差异均具有显著性意义（P〈0.01）。结论 3.0T MRI-DWI可较好地检出并鉴别乳腺良恶性病变性质。
Objective To explore the diagnostic value of 3. 0T magnetic resonance imaging（ 3. 0T MRI） in benign and malignant lesion of breast cancer. Methods A total of 70 nidi from 66 patients were included,and another 30 healthy women underwent physical examination of MRI for breast cancer were served as control. 3. 0T MRI diffusion-weighted imaging（ QWI） was conducted to scan mammary glands,with diffusion sensitized factor（ b value） being 50,450 and 850 s / mm2. Detection rate of nidi and DWI imaging manifestation were observed. The sensitivity,specificity,positive predictive value（ PPV） and negative predictive value（ NPV） of 3. 0T MRI-DWI on breast cancer were calculated with pathological diagnosis as the gold criteria. According to the pathological examination results,patients were divided into malignant lesion group,benign lesion group and healthy control group. Differences of apparent diffusion coefficient（ ADC） among 3 groups were observed under different b values. Results The detection rate of nidi was 94. 29%（ 66 /70）,in which 46 patients were with malignant lesion,and 20 cases with benign one. When b = 50 ~ 850 s / mm2,the threshold value of ADC was 1. 087 × 10-3mm2/ s,in which 6 cases were diagnosed as false positive and 5 cases with false negative. When b = 50 ~ 450 s / mm2,the threshold value of ADC was 1. 087 × 10-3mm2/ s,in which 9 cases were diagnosed as false positive and 7 cases with false negative. The sensitivity,specificity and PPV on malignant tumor were evidently higher while NPV was markedly lower when b = 50 ~850 s / mm2 than b = 50 ~ 450 s / mm2. Under different b values,ADC values were lower in malignant lesion than in benign lesion,and were also prominently lower in benign and malignant lesion groups than in control group,and all differences were significant（ P 0. 01）. Conclusion 3. 0T MRI-DWI can detect and identify the benign and malignant lesion of breast cancer well.
出处
《实用临床医药杂志》
CAS
2015年第19期73-76,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11523178)
关键词
乳腺病变
3.0T磁共振成像
弥散加权成像
表观弥散系数
mammary gland lesion
3.0T magnetic resonance imaging
diffusion-weighted imaging
apparent diffusion coefficient
