论文部分内容阅读
目的探讨动态增强磁共振成像(DCE-MRI)结合扩散加权成像(DWI对乳腺非肿块样强化(NMLE)的良恶性病变的鉴别诊断价值。方法搜集乳腺DCE-MRI表现为非肿块样强化病变的患者105例,均经病理证实。记录病灶分布特征、内部强化方式、时间信号曲线类型及ADC值,应用χ2检验、Fisher确切概率法、t检验及ROC曲线作统计学分析。结果所有病变中,恶性88例,良性17例。节段分布及簇状强化多见于恶性病变(P<0.05),分别占50.0%(44/88)和56.8%(50/88);弥漫分布及斑点样强化多见于良性病变(P<0.05),分别占29.4%(5/17)和29.4%(5/17);良恶性病变的ADC值分别为(1.20±0.22)×10-3mm2/s和(1.03±0.17)×10-3mm2/s,差异有统计学意义(P<0.05),以1.08×10-3mm2/s作为ADC值诊断淋巴结转移的阈值,灵敏度和特异度分别为63.6%、76.5%;而时间信号曲线类型在良恶性病变之间的差异无统计学意义(P>0.05)。结论通过分析MRI表现中的病变分布特征、内部强化方式及ADC值大小,可有效地鉴别乳腺非肿块样强化病变的良恶性。
Objective To investigate the differential diagnosis value between dynamic enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) for benign and malignant lesions of non-mass-enhanced breast lesions.Methods Collecting DCE-MRI of breast showed non-mass- All 105 patients were confirmed by pathology.The distribution of lesion, internal enhancement, time curve type and ADC value were recorded.χ2 test, Fisher’s exact test, t-test and ROC curve were used for statistical analysis.Results In all the lesions, 88 cases were malignant and 17 cases were benign.The segmental distribution and cluster enhancement were more common in malignant lesions (50.0% (44/88) and 56.8% (50/88) respectively), diffuse distribution and speckle enhancement (1.20 ± 0.22) × 10-3mm2 / s and (1.03 ± 0.32)% respectively in benign and malignant lesions (29.4% (5/17) and 29.4% 0.17) × 10-3mm2 / s, the difference was statistically significant (P <0.05). The sensitivity and specificity of the ADC value of 1.08 × 10-3mm2 / s for the diagnosis of lymph node metastasis were 63.6% and 76.5% There was no significant difference in the type of time signal curve between benign and malignant lesions (P> 0.05) .Conclusion By analyzing the features of lesions in MRI Wherein, the internal size of enhancement and ADC values, can effectively identify the non-mass-like enhancement of breast benign and malignant lesions.