基于体素内不相干运动的扩散加权成像对乳腺肿块病灶良恶性的诊断价值

发布时间：2018-04-22 22:26

  本文选题：磁共振扩散成像 + 体素内不相关运动　； 参考：《临床放射学杂志》2016年11期

【摘要】：目的探讨基于体素内不相干运动(IVIM)的扩散加权成像(DWI)对乳腺肿块病灶的诊断价值。方法前瞻性纳入术前行MRI检查且动态对比增强(DCE)表现为乳腺肿块的患者78例(87个病灶),分为良性组(n=29)与恶性组(n=58)。通过单、双指数模型分别获得表观扩散系数(ADC)、单纯水分子扩散系数(D)、灌注相关的扩散系数(D*)和灌注分数(f)参数值。采用独立样本t检验分析组间各参数差异。绘制受试者工作特征曲线(ROC),分析各参数对乳腺肿块病灶的诊断效能。结果恶性组ADC、D低于良性组(P0.001),恶性组D*高于良性组(P=0.04)。恶性组与良性组间f无明显差异(P0.05)。以病理为金标准,ADC、D、D*值诊断乳腺恶性肿块病灶的曲线下面积(AUC)分别为0.88、0.92、0.62,D与ADC间差异有统计学意义(P=0.03)。ADC、D、D*分别以1.19×10~(-3)mm~2/s、1.05×10~(-3)mm~2/s、7.55×10~(-3)mm~2/s为诊断阈值,敏感度分别为86.2%、89.7%、89.7%,特异度分别为89.7%、93.1%、37.9%,准确率分别为87.4%、89.7%、55.2%。结论 IVIM参数D对乳腺肿块病灶的诊断效能优于ADC,具有较高的敏感度和特异度,D*诊断效能一般,f诊断价值有限。
[Abstract]:Objective to evaluate the diagnostic value of diffusion-weighted imaging (DWI) based on voxel incoherent motion imaging (IVIMI) in breast masses. Methods 78 patients (87 lesions, divided into benign group (n = 29)) and malignant group (n = 58) who were performed MRI examination and dynamic contrast enhanced contrast enhanced MRI were divided into benign group (n = 87) and malignant group (n = 58). The parameters of apparent diffusion coefficient (ADCC), water molecular diffusion coefficient (DX), perfusion dependent diffusion coefficient (DU) and perfusion fraction (f) were obtained by single and double exponential models, respectively. T-test was used to analyze the difference of parameters between groups. The operating characteristic curve of the subjects was drawn to analyze the diagnostic effectiveness of each parameter for breast masses. Results ADCD in malignant group was lower than that in benign group (P 0.001), and D * in malignant group was higher than that in benign group (P 0.04). There was no significant difference between malignant group and benign group (P 0.05). 浠ョ梾鐞嗕负閲戞爣鍑，

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