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MR动态增强曲线、 DWI及ADC值用于乳 腺疾病定性诊断的 敏感性及特异性评 估

作者:刘世忠 吴雄娟 詹奕彦 庄 楠 郑则钦

所属单位:广东省汕头市第二人民医院放射科 (广东 汕头 515011)

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摘要

目的 探讨MR动态增强曲线、 弥散加权成像(diffusion weighted imaging,DWI)及表观扩散系数(apparent diffusion coefficient, ADC)值用于乳 腺疾病定性诊断的敏感性及特异性。方 法 收集2014年6月-2015年6月医院临床怀 疑乳腺肿块患者30例(30个病灶),均获手 术和病理证实,其中良性病灶17个,恶性 病灶13个。统计MR动态增强曲线、ADC值 及联合诊断诊断乳腺疾病的准确性、敏感 性和特异性。结果 以组织病理学为“金 标准”,MR动态增强曲线、ADC值及联合 诊断的准确性分别为76.67%、80.0%、 90.0%,敏感性为84.62%、84.62%、 92.31%,特异性为70.59%、76.47%、 88.24%。结论 MR动态增强曲线、ADC值联 合诊断乳腺疾病,能提高诊断准确性和特 异性。

Objective To explore the sensitivity and specificity of MR dynamic enhancement curve, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) value in the qualitative diagnosis of breast diseases. Methods 30 cases (30 lesions) of patients with suspected breast masses were collected from the hospital from June 2014 to June 2015. All cases were confirmed by surgery and pathology. Among them, 17 cases were benign lesions and 13 were malignant ones. The accuracy, sensitivity and specificity of MR dynamic enhancement curve, ADC value and combined diagnosis in diagnosis of breast diseases were statistically analyzed. Results With histopathology as the golden standard, the accuracies of MR dynamic enhancement curve, ADC value and combined diagnosis were 76.67%, 80.0% and 90.0%, respectively. The sensitivities were 84.62%, 84.62% and 92.31%, respectively. The specificities were 70.59%, 76.47% and 88.24% respectively. Conclusion MR dynamic enhancement curve and ADC value combined diagnosis in the diagnosis of breast diseases can improve the accuracy and specificity of diagnosis.

【关键词】乳腺疾病;磁共振成像;动态 增强;扩散加权成像;时间- 信号强度曲线

【中图分类号】R445.2; R737.9

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.10.022

前言

MR具有良好软组织分辨率、空间分辨率,是临床诊断乳腺病变的 重要影像学方法之一[1]。动态增强扫描诊断乳腺癌的敏感性高达85%, 但特异性尚不满意。因此,提高乳腺磁共振诊断准确性、特异性成为 影像学工作者关注重点。随着MR的发展,MR动态增强曲线、DWI等在 乳腺疾病诊断中得到广泛应用,有利于对乳腺疾病进行定性诊断。本 研究对纳入病例同时进行MR常规扫描、增强扫描、DWI扫描,计算ADC 值,并绘制时间-强度曲线,分析单一及联合应用诊断乳腺疾病的敏感 性和特异性,现报道如下。