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目的探讨MR扩散加权成像(DWI)的技术及表观扩散系数(ADC)值对乳腺良、恶性病变的诊断价值。方法经病理证实的乳腺病变53例:恶性病灶35个,良性病灶22个。扩散敏感系数(b值)取0、500、1000s/mm2,以恶性病变的ADC值95%可信区间的上界作为诊断病变良、恶性的界值,所得结果与病理结果比较。结果DWI显示95.5%(21/22)的良性病变,97.1%(34/35)的恶性病变,敏感性96.5%(55/57)。恶性病变组的ADC值与良性病变组或正常腺体组的ADC值差异均有统计学意义。我们把良、恶性病变ADC值的界值定为0.98×10-3mm2/s,即<0.98为恶性,>0.98为良性。乳腺ADC值随着b值的增大而减少。结论依据ADC值可以对乳腺良、恶性病变作出诊断和鉴别诊断;ADC值随着乳腺病变的不同和采用的b值的不同而改变,b值取1000s/mm2时对乳腺良、恶性病变的诊断最有价值。
Objective To investigate the diagnostic value of MR diffusion weighted imaging (DWI) technique and apparent diffusion coefficient (ADC) value in benign and malignant breast lesions. Methods Pathologically confirmed 53 cases of breast lesions: 35 malignant lesions, 22 benign lesions. Diffusion sensitivity coefficients (b values) were taken as 0,500,1000 s / mm2, and the upper bound of the 95% confidence interval for the ADC value of malignant lesions was used as a good and malignant cutoff value. The obtained results were compared with the pathological results. Results DWI showed 95.5% (21/22) benign lesions and 97.1% (34/35) malignant lesions with a sensitivity of 96.5% (55/57). ADC value of malignant lesions group and benign lesions or normal gland group ADC values were statistically significant. We set the cutoff value of benign and malignant lesions ADC values as 0.98 × 10-3mm2 / s, that is, <0.98 is malignant,> 0.98 is benign. The breast ADC value decreases with increasing b value. Conclusion According to ADC value, the diagnosis of benign and malignant breast lesions can be diagnosed and differentiated. The value of ADC changes with the difference of breast lesions and the value of b. The value of b is 1000s / mm2 in the diagnosis of benign and malignant breast lesions most valuable.