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1、MMIBIMONTHLYVol23No.3Jun2014—195一MRI平掃聯(lián)合DWI對(duì)乳腺良惡性病變?cè)\斷價(jià)值分析河南科技大學(xué)附屬三門(mén)峽黃河醫(yī)院MlqI科,乳腺科,病理科。(河南三門(mén)峽472000)荊彥平高崢嶸駱賓吳孔興張俊南曉東李景剛郭影【摘要】目的:探討MRI平掃聯(lián)合DWI對(duì)乳腺良惡性病變的診斷價(jià)值。材料與方法:對(duì)病理證實(shí)的70例患者M(jìn)RI常規(guī)平掃、擴(kuò)散加權(quán)成像(DWI)及表觀擴(kuò)散系數(shù)(ADC)值進(jìn)行回顧性分析,所有病例均采用SETWI、FSET2WI壓脂序列、單次激發(fā)自旋平面一回波成像(SE—EPI)序列行DWI掃描,擴(kuò)散敏感系
2、數(shù)(b值)取lO00s/mm。結(jié)果:70例病變中,乳腺癌49例,乳腺腺瘤19例,積乳囊腫2例。MRI平掃診斷乳腺良惡性病變的敏感性為61.2%(30/49),特異性為19%(4/21),準(zhǔn)確性為48.6%(34/70)。以病變信號(hào)對(duì)乳腺良惡性診斷檢出率比較無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。以惡性病變平均ADC值95%可信區(qū)間的上界1.203×10mm/s作為診斷良、惡性病變的界值,所得結(jié)果與病理結(jié)果比較,診斷敏感性為87.8%(43/49),特異性為85.7%(18/21),準(zhǔn)確性為87.1%(61/70)。MRI平掃聯(lián)合彌散加權(quán)成像AD
3、C值綜合診斷的敏感性為93.8%(46/49),特異性為90.5%(19/21),準(zhǔn)確性為92.8%(65/70)。結(jié)論:DWI及ADC值是診斷和鑒別診斷乳腺良、惡性病變的有價(jià)值方法;MRI平掃結(jié)合DWI成像能明顯提高乳腺良惡性病變?cè)\斷準(zhǔn)確性。關(guān)鍵詞:乳腺癌磁共振成像擴(kuò)散加權(quán)成儔AnalysisofDiagnosticValueofMRIPlanScanCombinationDWIinBreastBenignandMalignantLesionsJingYanpingGaoZhengrongLuoBinWuKongxingZhangJ
4、unNanXiaodongLiJinggangGuoYing1.MRDepartment,TheAffiliateHuangheSanmenxiaHospitalofHenanUniversityofScienceandTechnology;4720002.MammaryglandDepartment;3.PathologyDepartment【Abstract】Purpose:Tostudythediagnostic、alueofMRIplanscancombinationDWIinbreastbenignandmalignantl
5、esions.MaterialsandMethods:Inthe70casesofbreastlumpsprovedbypathologyandsurgerywereretrospectivelyana-lyzed.ExaminedroutineMRIscan,difusionweightedimaging(DWI)andapparentdifusioncoefficientvalue(ADC),pre-operatively,allcasesusingSET1WI,F(xiàn)SET2WIpressurefatseries,singleexc
6、itationplane—spinechoimaging(SE—EPI)toDWIscans,spreadsensitivecoeficientwas(b1000s,/mm).Results:Amongthe70cases,49caseswasbreastcancer,mammaryglandadenoma19cases,breastcyst2cases.ThesensitivityofMRIplanscanindiagnosisofbenignandmalignantbreastlesionswas61.2%(30/49),spec
7、ificitywas19%(4/21),accuracywas48.6%(34/70).Tosignalforbreastbe—nignandmalignantdiagnosisdetectionrateisnostatisticalsignificance(P>0.05).WithaverageADCvaluesofmalignantupperboundofthe95%confidenceinterval1.203x19~astheboundaryvalueofthediagnosisofbenignandmalignantle·s
8、ions,andresultscomparedwiththepathologicalresults,diagnosticsensitivitywas87.8%(43/49),specificitywas85.7%(18/