【摘要】 目的分析动态增强磁共振成像（DCE-MRI）和表观扩散系数（ADC）直方图用于鉴别乳腺良恶性病变的临床价值。方法回顾性收集2016年6月-2018年8月本院90例（90个病灶）的乳腺病变患者的临床资料,根据术后病理诊断结果分为良性组64例、恶性组26例。取得手术病理结果之前接收规范DCE-MRI、DWI检查,根据软件得出DCE-MRI定量参数,如容量转移常数(K^trans)、速率常数(K_ep)及血管外细胞外间隙容积分数（V_e）;重建ADC直方图,获取平均ADC值(ADC_mean)、最小ADC值(ADC_min)、最大ADC值(ADC_max)、ADC差值及直方图的偏度、峰度。结果与良性组比较,恶性组腺体K^trans、K_ep值显著高（P<0.05）,V_e值未见明显差异（P>0.05）。通过ROC曲线分析,K^trans、K_ep鉴别恶性、良性乳腺病变的敏感度均>80%,K_ep的特异度高达93.75%。与良性组比较,恶性组腺体ADC_mean、ADC_min、ADC_max均显著低,ADC差值显著高（P<0.05）,直方图的偏度、峰度未见明显差异（P>0.05）。通过ROC曲线分析,ADC_mean诊断鉴别恶性、良性乳腺病变敏感度、特异度最高,为80.77%和92.19%,其次为ADC差值的敏感度较高和ADC_min的特异度较高。结论 DCE-MRI和ADC直方图对鉴别乳腺良恶性病变有较高的临床应用价值。更多还原

【Abstract】 Objective To analyze the clinical value of dynamic contrast enhanced magnetic resonance imaging（DCE-MRI） and apparent diffusion coefficient（ADC） histogram in the identification of benign and malignant breast lesions. Methods The clinical data of 90 patients（90 lesions） with breast lesions in the hospital from June 2016 to August 2018 were retrospectively collected. According to the postoperative pathological diagnostic results, they were divided into benign group（64 cases） and malignant group（26 cases）. The standardized DCE-MRI and diffusion weighted imaging（DWI） examination were performed before obtaining surgical pathological results. The DCE-MRI quantitative parameters such as volume transfer constant(K^trans), rate constant(K_ep) and the extravascular-extracellular volume fraction（V_e） were obtained according to the software. The ADC histogram was rebuilt. The mean value of ADC(ADC_mean), minimum value of ADC(ADC_min), maximum value of ADC(ADC_max), difference value of ADC, skewness and kurtosis of histogram were obtained. Results Compared with the benign group, the values of K^trans and K_ep of the gland in the malignant group were significantly higher（P<0.05）. There was no significant difference in the V_e value between the two groups（P>0.05）. Through the analysis by ROC curve, the sensitivity for the differentiation of malignant and benign breast lesions by K^trans and K_ep was greater than 80%. The specificity for that by K_ep was as high as 93.75%. Compared with the benign group, the ADC_mean, ADC_min and ADC_max of the malignant group were significantly lower, the difference value of ADC was significantly higher（P<0.05）. There was no significant difference in the skewness and kurtosis of histogram between the two groups（P>0.05）. Through the analysis by ROC curve, the sensitivity and specificity for the diagnosis and differentiation of malignant and benign breast lesions by ADC_mean were the highest（80.77% and 92.19%）, followed by the sensitivity examined by ADC difference and the specificity examined by ADC_min. Conclusion DCE-MRI and ADC histogram have high clinical value in the identification of benign and malignant breast lesions.更多还原