Luo Yi, Yu Jianqun, Chen Dongdong, Xu Zhongzi, Zeng Hanjiang
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2013 Dec;30(6):1219-23.
We studied the actions of diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) in differentiating breast tumors. From January 2010 to February 2012, we retrospectively analyzed data of 95 cases with breast tumor pathologically confirmed from DWI and DCE-MRI. We compared the ADC value, time-intensity curve (TIC) and DCE-MRI parameters between breast tumors, and calculated the sensitivity and specificity for differentiating breast tumors. The results were as follows: (1) On DWI, mean ADC value of malignant tumor was lower than that of benign tumor (P < 0.05). For differentiating breast malignant tumors from benign neoplasm, a cut-off ADC value of 1.2 x 10(-3) mm2/s achieved a sensitivity of 74.1% and specificity of 70.3%. (2) On DCE-MRI, early enhancement ratio (EER) value of malignant tumor was higher than that of benign tumor whereas value of time to peak (Tpeak) and maximal enhancement ratio (SImax) were lower than that of benign tumor (all P < 0.05). As for TIC, type II and III were more frequently seen in malignant tumor than in benign tumor whereas type I was more common in benign tumor than in malignant tumor (all P < 0.05). For differentiating breast malignant tumors from benign neoplasm, DCE-MRI obtained a sensitivity of 89.7% and specificity of 70.3%. (3) For differentiating breast malignant tumors from benign neoplasm, ADC value together with TIC obtained a sensitivity of 79.3% and specificity of 78.4%. Malignant or benign breast tumors could have their own unique characteristics on DWI and DCE-MRI. These characteristics might be helpful for differentiating these tumors.
我们研究了扩散加权成像（DWI）和动态对比增强（DCE）磁共振成像（MRI）在鉴别乳腺肿瘤中的作用。2010年1月至2012年2月，我们回顾性分析了95例经病理证实的乳腺肿瘤患者的DWI和DCE-MRI数据。我们比较了乳腺肿瘤之间的表观扩散系数（ADC）值、时间-强度曲线（TIC）和DCE-MRI参数，并计算了鉴别乳腺肿瘤的敏感性和特异性。结果如下：（1）在DWI上，恶性肿瘤的平均ADC值低于良性肿瘤（P<0.05）。对于鉴别乳腺恶性肿瘤和良性肿瘤，ADC值截断点为1.2×10⁻³mm²/s时，敏感性为74.1%，特异性为70.3%。（2）在DCE-MRI上，恶性肿瘤的早期增强率（EER）值高于良性肿瘤，而达峰时间（Tpeak）和最大增强率（SImax）值低于良性肿瘤（均P<0.05）。至于TIC，Ⅱ型和Ⅲ型在恶性肿瘤中比在良性肿瘤中更常见，而Ⅰ型在良性肿瘤中比在恶性肿瘤中更常见（均P<0.05）。对于鉴别乳腺恶性肿瘤和良性肿瘤，DCE-MRI的敏感性为89.7%，特异性为70.3%。（3）对于鉴别乳腺恶性肿瘤和良性肿瘤，ADC值联合TIC的敏感性为79.3%，特异性为78.4%。乳腺良恶性肿瘤在DWI和DCE-MRI上可能有各自独特的特征。这些特征可能有助于鉴别这些肿瘤。
