目的探究动态增强磁共振成像 (DCE-MRI)定量渗透性参数联合磁共振弥 散加权成像(DWI)定量分析在乳腺良恶性 病变中的诊断价值。方法 回顾性分析我 院2016年12月-2017年12月经手术病理证 实的64例乳腺病变患者(浸润性导管癌45 例，纤维腺瘤19例)临床病例，另选取同 期正常乳腺20例为对照组。所有病例均于 术前1周行3.0T MRI平扫、DWI(弥散敏感 因b=1000s/mm2 )、DCE-MRI检查，测量病 灶表观扩散系数(ADC值)及容量转移常数 (Ktrans值)，并与检查后经手术或穿刺获得 病理结果。结果 浸润性导管癌与纤维腺 瘤、浸润性导管癌与对照组、纤维腺瘤与 对照组各组间ADC值、Ktrans值比较，差异 均具有统计学意义(P<0.05)；以病理结果 为金标准，ADC值联合Ktrans值鉴别乳腺良 恶性病变的敏感性、特异性、准确性均 高于单独使用ADC值及Ktrans值鉴别。结论 DCE-MRI定量渗透性参数Ktrans值与DWI定量 分析ADC值联合诊断，不仅可反映肿瘤形 态学信息，还可反映肿瘤内部细胞水平及 血管功能方面的信息，提高乳腺良恶性病 变定性诊断价值，为临床治疗方案的选择 及患者预后提供新的思路。

Objective To explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative permeability parameters combined with magnetic resonance diffusion-weighted imaging (DWI) in the diagnosis of benign and malignant breast lesions. Methods The clinical data of 64 patients with breast lesions (45 cases of invasive ductal carcinomas, 19 cases of fibroadenomas) confirmed by operation and pathology in the hospital during December 2016 to December 2017 were analyzed retrospectively. 20 cases with normal breast were selected as the control group at the same time. All cases were examined by 3.0T MRI plain scan, DWI (diffusion-sensitive factor b=1000s/mm2 ) and DCE-MRI at 1 week before operation. The apparent diffusion coefficient (ADC value) and the volume transfer constant (Ktrans value) of the lesion were measured. The pathological results were obtained after operation or puncture. Results There were statistically significant differences of ADC value and Ktrans value between invasive ductal carcinoma and fibroadenoma, between invasive ductal carcinoma and control group, between fibroadenoma and control group (P<0.05). With pathological results as the golden standard, the sensitivity, specificity and accuracy of ADC value combined with Ktrans value in differentiating benign and malignant breast lesions were higher than those of ADC value or Ktrans alone. Conclusion The combined diagnosis of DCE-MRI quantitative permeability parameter Ktrans value and DWI quantitative analysis ADC value not only can reflect the tumor morphological information, but also can reflect information such as the tumor cell level and vascular functional, and improve the value of qualitative diagnosis of benign and malignant breast lesions, which provides new ideas for clinical treatment for patients.