乳腺占位性病变内液性信号区表观扩散系数对病变性质的诊断价值研究

发布时间：2018-04-11 14:43

本文选题：乳腺占位性病变 + 扩散加权成像　；参考：《临床放射学杂志》2017年05期

【摘要】：目的探讨乳腺占位性病变内液性信号区MRI表观扩散系数(ADC)值对病变性质的鉴别诊断价值。方法回顾性分析内含液性区并经病理证实的54例乳腺疾病患者资料,根据其病理结果分为恶性肿瘤组(28例)、良性肿瘤组(13例)、炎性病变组(13例)。术前行MRI扫描,测量病变内液性区域ADC值,并采用单因素方差分析,比较三组乳腺病变内平均ADC值的差异性。采用受试者工作特征曲线(ROC)分析液性区ADC值对乳腺病变性质的诊断效能。结果乳腺恶性肿瘤组、良性肿瘤组和炎性病变组液性区的ADC均值分别为(2.03±0.52)×10~(-3)mm~2/s、(1.99±0.56)×10~(-3)mm~2/s和(1.17±0.66)×10~(-3)mm~2/s,差异具有统计学意义(F=11.242,P0.01)。确定1.61×10~(-3)mm~2/s作为肿瘤性病变与炎性病变的鉴别诊断阈值时,其诊断敏感度、特异度以及约登指数分别为83%、77%和0.60;取1.61×10~(-3)mm~2/s作为恶性肿瘤与炎性病变的鉴别诊断阈值时,其诊断敏感度、特异度以及约登指数分别为89%、77%和0.66;采用1.32×10~(-3)mm~2/s作为鉴别良性占位性病变和炎性病变的诊断阈值时,其诊断敏感度、特异度以及约登指数分别为85%、69%和0.54。结论乳腺占位性病变液性区ADC值对于乳腺恶性肿瘤与炎性病变的鉴别具有较高的应用价值,能够为临床诊断提供一条新的途径。
[Abstract]:Objective to investigate the value of MRI apparent diffusion coefficient (MRI) in the fluid signal region of breast occupying lesions in the differential diagnosis of lesions.Methods the data of 54 patients with breast disease confirmed by pathology were retrospectively analyzed. According to the pathological results, they were divided into malignant tumor group (n = 28), benign tumor group (n = 13) and inflammatory lesion group (n = 13).Preoperative MRI scanning was performed to measure the ADC value in the fluid region of the lesion. The difference of the mean ADC value in the three groups was compared by single factor analysis of variance (ANOVA).The effectiveness of ADC value of fluid region in diagnosis of breast lesions was analyzed by means of operating characteristic curve (OC).The diagnostic sensitivity, specificity and Jordan index of 1. 61 脳 10~(-3)mm~2/s as the threshold for differential diagnosis of malignant and inflammatory lesions were 83 77% and 0. 60%, respectively, while 1. 61 脳 10~(-3)mm~2/s was used as the diagnostic threshold for the differential diagnosis of malignant and inflammatory lesions.The diagnostic sensitivity, specificity and Yorden index were 850.69% and 0.54 when 1.32 脳 10~(-3)mm~2/s was used as the diagnostic threshold for differentiating benign and inflammatory lesions.Conclusion the value of ADC in the fluid area of breast occupying lesions is of great value in the differential diagnosis of malignant and inflammatory lesions of breast, and it can provide a new way for clinical diagnosis.
【作者单位】：广西医科大学附属肿瘤医院影像中心;
【基金】：广西壮族自治区科学技术厅科技攻关计划项目(编号:桂科攻14124004-1-11)
【分类号】：R445.2;R737.9

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