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为探讨扩散加权成像(DWI)及动态增强MRI(DCE-MRI)在鉴别诊断乳腺良恶性肿瘤中的价值。本研究回顾分析2010年1月-2012年2月本院95例经病理证实的乳腺肿瘤MRI扩散加权成像及动态增强资料。比较乳腺良恶性肿瘤的ADC值、动态增强扫描的时间-信号强度曲线(TIC)及其相关参数,统计分析其在鉴别良恶性肿瘤中的灵敏度及特异度。结果发现(1)DWI:恶性肿瘤的平均ADC值较良性肿瘤的低(P<0.05)。将ADC值<1.2×10-3 mm2/s的病例诊断为恶性肿瘤,灵敏度为74.1%,特异度为70.3%。(2)DCE-MRI:恶性肿瘤的早期强化率(EER)明显高于良性(P<0.05),强化达峰时间(Tpeak)及最大强化率(SImax)则低于良性(P<0.05)。TIC类型:恶性肿瘤多表现为Ⅱ、Ⅲ型曲线,良性肿瘤多表现为Ⅰ型曲线(P<0.05)。动态增强鉴别良恶性肿瘤的灵敏度为89.7%,特异度为70.3%。(3)ADC值联合TIC类型诊断良恶性肿瘤,灵敏度为79.3%,特异度为78.4%。乳腺良恶性肿瘤的DWI及DCI-MRI各具特征,对乳腺肿瘤良恶性的鉴别诊断有着重要的临床意义。
To investigate the value of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differential diagnosis of benign and malignant breast tumors. This study retrospectively analyzed 95 cases of pathologically confirmed breast tumor MRI diffusion weighted imaging and dynamic enhancement data from January 2010 to February 2012 in our hospital. To compare the ADC value of breast benign and malignant tumors, the time-signal intensity curve (TIC) of dynamic contrast-enhanced scanning and its related parameters, and to analyze the sensitivity and specificity of the method in the differential diagnosis of benign and malignant tumors. The results showed that (1) DWI: The average ADC value of malignant tumors was lower than that of benign tumors (P <0.05). Patients with ADC values <1.2 × 10-3 mm2 / s were diagnosed as malignant tumors with a sensitivity of 74.1% and a specificity of 70.3%. (2) DCE-MRI: The early-stage enhancement rate (EER) of malignant tumors was significantly higher than that of benign ones (P <0.05). The Tpeak and SImax of malignant tumors were lower than those of benign ones (P <0.05). TIC type: malignant tumors mostly manifested as type II, type III curve, benign tumors showed more type Ⅰ curve (P <0.05). The sensitivity and specificity of dynamically enhanced benign and malignant tumors were 89.7% and 70.3% respectively. (3) ADC value combined with TIC type diagnosis of benign and malignant tumors, the sensitivity was 79.3%, the specificity was 78.4%. The characteristics of DWI and DCI-MRI in breast benign and malignant tumors are of important clinical significance in the differential diagnosis of benign and malignant breast tumors.