【摘要】 目的 探讨多模态磁共振成像对乳腺腺病及非钙化型乳腺癌的诊断效能，以提高对这两种病变的诊断准确性。方法 选取我院经病理证实为乳腺腺病患者42例，非钙化型乳腺癌患者50例，所有患者均行数字化乳腺X线摄影检查及多模态磁共振成像检查。以病理结果作为金标准，计算DWI和DCE-MRI两种技术单独诊断及联合诊断乳腺腺病和非钙化型乳腺癌的诊断效能。结果 乳腺腺病组和非钙化型乳腺癌组平均ADC值分别为（1.064±0.252）×10^-3 mm²/s、（0.716±0.159）×10^-3 mm²/s（t值=7.737,P=0.000）,差异具有统计学意义。以病理结果作为金标准绘制ROC曲线，以ADC值0.815×10^-3 mm²/s作为两组良恶性病变的截断值，其诊断灵敏度、特异度、准确率、PPV、NPV及AUC分别为82.00%、90.48%、85.87%、91.11%、80.85%及0.897。DCE-MRI的诊断灵敏度、特异度、准确率、PPV、NPV及AUC分别为94.00%、78.57%、86.96%、83.93%、91.67%及0.863。DCE-MRI联合DWI诊断中，诊断灵敏度、特异度、准确率、PPV、NPV及AUC分别为96.00%、71.43%、84.78%、80.00%、93.75%及0.837。结论 多模态磁共振成像对乳腺腺病及非钙化型乳腺癌的诊断效能DCE-MRI准确度最高，DWI（ADC值）的特异度及AUC最高，联合DCE-MRI及DWI诊断时，灵敏度最高。更多还原

【Abstract】 Objective To explore the diagnostic value of multi-mode MRI for breast adenosis and non-calcified breast cancer, in order to improve the diagnostic accuracyof breast adenosis and non-calcified breast cancer. Methods 42 cases of breast adenosis and 50 cases of non-calcified breast cancer confirmed by pathology were enrolled in the study in Lujiang People’s Hospital of Anhui province. All patients were performed digital mammography and multi-mode MRI. The diagnosis value of DWI, DCE-MRI and two techniques for diagnosing breast adenosis and non-calcified breast cancer were calculated respectively. Results The average ADC values of the breast adenosis group and non-calcified breast cancer group were（1.064±0.252）×10^-3 mm²/s and（0.716±0.159）×10^-3 mm²/s respectively（t=7.737, P=0.000）, the difference between the two groups was statistically significant. When the ADC value was 0.815 ×10^-3 mm²/s as the cut-off value of benign and malignant lesions in the two groups, the diagnostic sensitivity, specificity, accuracy, PPV, NPV and AUC were 82.00%, 90.48%, 85.87%, 91.11%, 80.85% and 0.897 respectively. The diagnostic sensitivity, specificity, accuracy, PPV, NPV and AUC of DCE-MRI were 94.00%, 78.57%, 86.96%, 83.93%, 91.67% and 0.863%, respectively. In the diagnosis of DCE-MRI combined with DWI, the diagnostic sensitivity, specificity, accuracy, PPV, NPV and AUC were 96.00%, 71.43%, 84.78%, 80.00%, 93.75% and 0.837 respectively. Conclusion Multi-mode MRI has the highest diagnostic accuracy of DCE-MRI for breast adenosis and non-calcified breast cancer. The specificity and AUC of DWI（ADC） are the highest, and the sensitivity is the highest when combined with DCE-MRI and DWI.更多还原