【摘要】 目的初步探讨体素内不相干运动扩散加权成像(IVIM-DWI)在乳腺良、恶性病变鉴别诊断中的应用。方法测量60例行1.5T磁共振扫描的乳腺疾病患者病变的IVIM参数:标准扩散系数(Standard ADC)、真实扩散系数(Slow ADC)、灌注相关扩散系数(Fast ADC)及灌注系数f(Fraction)值。根据病理结果将患者分为良、恶性病变组,并取其自身对侧正常的乳腺组织为对照组,对3组的定量参数进行统计学分析。比较3组的组内Standard ADC、Slow ADC值的差别,分析其ROC曲线。结果对照组、良性病变与恶性病变组的Standard ADC、Slow ADC值依次降低,且两两比较差别有统计学意义(P<0.01);对照组、良性病变与恶性病变组的Fast ADC、Fraction值依次升高,进一步两两比较,Fraction值的差别有统计学意义(P<0.01),Fast ADC值仅对照组与良性病变组间的差别有统计学意义(P<0.01)。3组组内Standard ADC和Slow ADC值的差别有统计学意义(P<0.01),Slow ADC的ROC曲线下面积大于Standard ADC。结论 IVIM-DWI对乳腺良恶性病变的鉴别诊断有意义,可提高诊断的敏感性。更多还原

【Abstract】 Objective To investigate the value of parameters derived by IVIM-DWI in differentiatial diagnosis of benign and malignant breast lesions. Methods Sixty patients underwent MRI at 1.5T had pathology-proven diagnosis. All lesions were identified using the following parameters:Standard ADC,Slow ADC,Fast ADC and Fraction. All the parameters of malignant,benign and normal glandular tissues were analyzed. The differences between Standard ADC and Slow ADC were analyzed.Results Mean Standard ADC and Slow ADC were lower in malignant tumors than that in benign lesions. Mean Standard ADC and Slow ADC were higher in normal glandular than that in benign lesions. There were significant differences between malignant and benign lesions,malignant lesions and normal glandular tissues,benign lesions and normal glandular tissues in mean Standard ADC and Slow ADC. Mean Fast ADC and Fraction was higher in malignant tumors than that in benign lesions. Mean Fast ADC and Fraction was lower in normal glandular tissues than that in benign lesions. There were significant differences between malignant and benign lesions,malignant lesions and normal glandular tissues in mean Fraction.Mean Fast ADC showed no significant differences between malignant and benign lesions,malignant lesions and normal glandular tissues but between benign lesions and normal glandular. There were essential differences between mean Standard ADC and mean Slow ADC in all groups. Area under the ROC of Slow ADC was bigger than that of Standard ADC. Conclusion IVIM-MRI has potential role in estimating the benign and malignant breast lesions. Using IVIM-DWI increases the sensitivity of differentiating malignant lesions from benign tissues.更多还原