动态增强MRI及DWI对乳腺导管原位癌和腺病的诊断

发布时间：2019-01-10 11:49

【摘要】：目的探讨动态增强磁共振成像(DCE-MRI)联合扩散加权成像(DWI)对乳腺导管原位癌(DCIS)和腺病的诊断价值。方法搜集74例经病理证实的乳腺疾病患者的MRI资料,其中DCIS 38例、腺病36例,术前均行DCE-MRI及DWI。统计病灶的形态学特征、时间-信号强度曲线(TIC)及表观扩散系数(ADC)值,并运用χ2检验和t检验分析DCIS和腺病组差异;采用受试者工作特征曲线(ROC)确定DCIS和腺病的ADC界值。结果 DCIS和腺病均以非肿块样强化多见(96.8%,94.4%),前者以导管样、节段样强化为主(22/38,57.8%),后者以区域性、弥漫性强化为主(20/36,55.5%);DCIS以均匀强化多见(15/38,39.5%),而以点簇样强化更具特征性。乳腺腺病多表现为不均匀强化(21/36,58.3%),且强化方式多变;Ⅰ型TIC多见于乳腺腺病(18/36,50%),而Ⅲ型曲线多见于DCIS(13/38,34.2%),Ⅱ型曲线在两者之间无显著差异。DCIS的ADC值(1.048±0.163)×10~(-3)mm~2/s显著低于乳腺腺病ADC值(1.521±0.323)×10~(-3)mm~2/s(b=800 s/mm~2),差异具有统计学意义(P0.0001)。根据ROC曲线确定ADC界值为1.30×10~(-3)mm~2/s,诊断敏感性和特异性分别为79.8%、81.8%(b=800 s/mm~2)。结论DCE-MRI有助于鉴别DCIS和乳腺腺病,联合DWI能够提高诊断效能。
[Abstract]:Objective to evaluate the diagnostic value of dynamic enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion weighted imaging (DWI) in the diagnosis of ductal carcinoma in situ (DCI) and adenopathy. Methods MRI data of 74 patients with breast disease confirmed by pathology were collected, including 38 cases of DCIS and 36 cases of adenosis. DCE-MRI and DWI. were performed before operation. The morphological characteristics, time-signal intensity curve (TIC) and apparent diffusion coefficient (ADC) of the lesions were analyzed. The difference between DCIS and adenosis was analyzed by 蠂 2 test and t test. The ADC bounds of DCIS and adenosis were determined by using the operating characteristic curve (ROC) of the subjects. Results Non-tumor-like enhancement was more common in DCIS and adenosis (96.80.94%), the former was catheter-like and segmental enhancement (22 / 38-57.8%), the latter was regional and diffuse (20 / 36,55.5%). Uniform enhancement was more common in DCIS (15 / 38%, 39.5%), while cluster enhancement was more characteristic. Most of the adenosis of mammary gland showed uneven enhancement (21 / 36) (58.3%), and the pattern of enhancement was varied. Type I TIC was more commonly seen in adenosis of the breast (18 / 36 / 50%), while type 鈪，

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