体素内不相干运动双指数模型评价乳腺肿块样病变

发布时间：2018-03-31 00:00

本文选题：乳腺肿瘤　切入点：扩散磁共振成像　出处：《中国医学影像技术》2015年07期

【摘要】：目的应用体素内不相干运动(IVIM)双指数模型探讨真性弥散系数(D)、与灌注相关的假性弥散系数(D*),灌注分数(f)在诊断乳腺肿块样病变诊断中的应用价值。方法收集经病理证实的乳腺恶性肿块48例(恶性组)、良性肿块26例(良性组)及正常体检者19名(对照组),均行常规MRI检查及多b值的弥散加权成像检查。比较3组间D值、f值、D*值及ADC值的差异,采用ROC曲线评估各个指标对乳腺良恶性肿块样病变的诊断效能。结果对照组、良性组及恶性组间D、f、D*及ADC值的差异均有统计学意义(P均0.01)。良性组D值低于对照组、且高于恶性组(P均0.01);恶性组f值高于对照组及良性组(P均0.01),而对照组与良性组间差异无统计学意义(P=0.14);良性组D*值低于对照组、高于恶性组(P均0.01);良性组ADC值低于对照组、高于恶性组(P均0.01)。恶性组的D值显著低于ADC值(P0.01)。分析采用各DWI参数鉴别诊断乳腺恶性肿块样变的ROC曲线,D值具有较高的诊断效能,其次依次为ADC值,f值及D*值,曲线下面积(AUC)依次为0.95、0.90、0.87、0.75。结论 IVIM双指数模型能够真实反映乳腺肿块样病变水分子的弥散情况,尤其是D值对乳腺病变良恶性的鉴别诊断具有重要的参考意义。
[Abstract]:Objective to investigate the diagnostic value of true diffusion coefficient (DG), pseudo-diffusive coefficient (PSD) and perfusion fraction (F) in diagnosis of breast tumor-like lesions by using the IVIM-VIVIMM model. Methods the clinical data of dysmenorrhea were collected. 48 cases of malignant breast masses (malignant group, 26 cases of benign mass) and 19 cases of normal physical examination (control group) were examined by conventional MRI and diffusion-weighted imaging with multiple b values. The difference between the value of D * and the value of ADC, ROC curve was used to evaluate the diagnostic efficacy of each index for benign and malignant breast tumor-like lesions. Results there were significant differences in D * and ADC values among the control group, benign group and malignant group (P < 0.01). The D value of benign group was lower than that of control group. The F value of the malignant group was higher than that of the control group and the benign group, but there was no significant difference between the control group and the benign group, the D * value of the benign group was lower than that of the control group and higher than that of the malignant group, and the ADC value of the benign group was lower than that of the control group. The D value of malignant group was significantly lower than that of ADC value (P 0.01). The value of ROC curve D in differential diagnosis of malignant breast mass by DWI parameters was higher than that in malignant tumor group (P < 0.01), followed by ADC value F value and D * value, and the value of D value was higher than that of malignant tumor group (P < 0.01), and the D value of malignant group was significantly lower than that of ADC value (P < 0.01). The area under the curve is 0.950.90 / 0.870.75.Conclusion the IVIM double index model can truly reflect the diffusion of water molecules in breast tumor-like lesions, especially the D value is of great significance for the differential diagnosis of benign and malignant breast lesions.
【作者单位】：南方医科大学附属深圳市妇幼保健院放射科;深圳市第二人民医院介入治疗科;北京大学深圳医院医学影像中心;
【分类号】：R445.2;R737.9

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