目的研究3.0T MRI多b值 DWI(MB-DWI)序列在乳腺良恶性病变中的 诊断价值。方法 对2015年3月至2018年3 月我院106例女性乳腺疾病患者以及60例 同期健康体检者进行MRI常规扫描和MBDWI检查，并以病理检查结果为“金标 准”分析乳腺疾病患者标准化表观弥散 系数(ADCstandard)，快、慢速ADC(ADCfast、 ADCslow)以及快速扩散所占比例(ffast)在 良、恶性病变及正常乳腺组织的差异以 及各项参数对乳腺良恶性疾病鉴别诊断 价值。结果 106例患者中良性病变61例 (57.55%)，其中最常见为纤维腺瘤36例 (33.96%)；恶性病变45例(42.45%)，主要 为浸润性非特殊型癌23例(21.70%)，良恶 性病变结节分布情况差异无统计学意义 (P>0.05)；乳腺良恶性病变T1WI和T2WI信 号特点分布情况无明显差异(P>0.05)； 正常乳腺、乳腺良性病变、恶性病变 ADCslow、ffast、ADCstandard均依次降低， ADCfast依次升高，三组差异有统计学意 义(P<0.05)；MB-DWI各参数诊断乳腺良 恶性病变AUC从小到大依次为ADCstandard、 ADCfast、ffast、ADCslow。结论 MB-DWI序列 检查可从分子水平反映乳腺疾病病灶的生 物学行为，对鉴别良恶性病变具有重要参 考价值，其中以ADCslow、ffast诊断价值较 高。

Objective To explore the diagnostic value of multiple b value DWI (MBDWI) sequence of 3.0T MRI in benign and malignant breast lesions. Methods A total of 106 cases of female patients with breast lesions and 60 cases of healthy examiners in our hospital from March 2015 to March 2018 were examined by MRI routine scanning and MB-DWI. The pathological examination results were taken as "gold standard" to analyze the proportions of standardized apparent diffusion coefficient (ADCstandard), ADCfast, ADCslow and fast-diffusion (ffast) in benign and malignant lesions and normal breast tissues and the diagnostic value of various parameters for benign and malignant breast lesions. Results Among 106 patients, 61 cases (57.55%) were benign lesions with 36 cases (33.96%) of fibroadenoma, and 45 cases (42.45%) were malignant lesions with 23 cases (21.70%) were non-special type invasive carcinoma. There was no statistically significant difference in the distribution of benign and malignant nodules (P>0.05). There was no significant difference in the distribution of signal features on T1WI and T2WI between benign and malignant breast lesions (P>0.05). ADCslow, ffast, and ADCstandard were decreased successively while ADCfast was increased successively in normal breast, benign breast lesions and malignant lesions (P<0.05). The AUCs of various parameters of MB-DWI in the diagnosis of benign and malignant breast lesions from the smallest to the largest were ADCstandard, ADCfast, ffast and ADCslow. Conclusion MB-DWI sequence can reflect the biological behavior of breast lesions from the molecular level, and it has important reference value for the differentiation of benign and malignant lesions, and the ADCslow and ffast have higher diagnostic value.