Yoo Hyunkyung, Shin Hee Jung, Baek Seunghee, Cha Joo Hee, Kim Hyunji, Chae Eun Young, Kim Hak Hee
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea; Department of Radiology, Inha University Hospital, College of Medicine, Inhang-Ro 27, Shin-Heung Dong, Joon-Gu, Incheon, South Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 86 Asanbyeongwon-gil Songpa-gu, Seoul, South Korea.
Magn Reson Imaging. 2014 Sep;32(7):867-74. doi: 10.1016/j.mri.2014.04.012. Epub 2014 Apr 24.
To evaluate the diagnostic performance of an apparent diffusion coefficient (ADC) and quantitative kinetic parameters in patients with newly diagnosed breast cancer.
We enrolled 169 lesions in 89 patients with breast cancer who underwent dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI). Comparisons between benign and malignant lesions were performed for lesion type (mass or nonmass-like enhancement), size (≥1cm or<1cm), ADC, kinetic parameters and the presence of a US correlate.
There were 63 benign and 106 malignant lesions. The mean size and initial peak enhancement of the benign lesions were significantly lower than those of malignant lesions (P<0.001 for both). The ADC of the benign lesions was significantly higher than that of malignant lesions (1.42×10(-3)mm(2)/sec vs. 1.04×10(-3)mm(2)/sec; P<0.001). The area under the receiver operating characteristic curve (AUC) for predicting malignancy was 0.87 for the combined parameters of size, ADC, and initial peak enhancement, which was higher than those of each parameter.
Combination of quantitative kinetic parameters and ADC showed higher diagnostic performance for predicting malignancy than each parameter alone for the evaluation of patients with breast cancer.
评估表观扩散系数（ADC）和定量动力学参数对新诊断乳腺癌患者的诊断效能。
我们纳入了89例接受动态对比增强磁共振成像（DCE-MRI）和扩散加权成像（DWI）的乳腺癌患者的169个病灶。对良性和恶性病灶在病灶类型（肿块或非肿块样强化）、大小（≥1cm或<1cm）、ADC、动力学参数以及是否存在超声相关表现方面进行比较。
有63个良性病灶和106个恶性病灶。良性病灶的平均大小和初始峰值强化显著低于恶性病灶（两者P均<0.001）。良性病灶的ADC显著高于恶性病灶（1.42×10⁻³mm²/秒对1.04×10⁻³mm²/秒；P<0.001）。对于大小、ADC和初始峰值强化的联合参数，预测恶性的受试者操作特征曲线下面积（AUC）为0.87，高于各参数单独的AUC。
在评估乳腺癌患者时，定量动力学参数和ADC的联合对于预测恶性的诊断效能高于各参数单独使用时。
