扩散加权成像及表观扩散系数值在乳腺良恶性病变鉴别诊断中的价值

The diagnostic value of diffusion-weighted imaging and the apparent diffusion coefficient values in the differentiation of benign and malignant breast lesions.

作者信息

Çabuk Gonca, Nass Duce Meltem, Özgür Anıl, Apaydın Feramuz Demir, Polat Ayşe, Orekici Gülhan

机构信息

Department of Radiology, School of Medicine, Mersin University, Mersin, Turkey.

出版信息

J Med Imaging Radiat Oncol. 2015 Apr;59(2):141-8. doi: 10.1111/1754-9485.12273. Epub 2015 Jan 7.

DOI:10.1111/1754-9485.12273

PMID:25564776

Abstract

INTRODUCTION

The goal of our study was to evaluate the diagnostic efficacy of diffusion-weighted imaging (DWI) in the differentiation of benign and malignant breast lesions.

METHODS

Between June 2012 and March 2013, 60 patients with 63 lesions (age range 29-70 years, mean age 48.6 years) were included in our study. All lesions, except complicated cysts and intra-mammary lymph nodes, were confirmed histopathologically. The patients were evaluated with a 1.5 Tesla MR scanner using dedicated bilateral breast coil. DWI images were obtained by echo planar imaging sequence and 'b' values were selected as 200, 600 and 1000 s/mm(2). Apparent diffusion coefficient (ADC) values of both breast lesions and the normal fibroglandular tissue of the contralateral breast were calculated and statistically compared using Shapiro-Wilk test, Student's t-test, Mann-Whitney U test, chi-square test and the receiver operating curve.

RESULTS

Of 63 lesions, 22 were malignant and 41 were benign. In malignant lesions, the mean ADC values were 1.40 ± 0.41 × 10(-3) mm(2)/s for b = 200, 1.05 ± 0.28 × 10(-3) mm(2)/s for b = 600 and 0.91 ± 0.20 × 10(-3) mm(2)/s for b = 1000 and in benign lesions, the mean ADC values were 2.13 ± 0.85 × 10(-3) mm(2)/s for b = 200, 1.64 ± 0.47 × 10(-3) mm(2)/s for b = 600 and 1.40 ± 0.43 × 10(-3) mm(2)/s for b = 1000. The success of ADC values in differentiation of benign and malignant lesions was statistically significant (P = 0.0001). The threshold values were determined to be 1.50 × 10(-3) mm(2)/s for b = 200, 1.22 × 10(-3) mm(2)/s for b = 600 and 0.98 × 10(-3) mm(2)/s for b = 1000 (P < 0.05).

CONCLUSION

DWI can be an effective radiological method in the differentiation of benign and malignant breast lesions.

摘要

引言

我们研究的目的是评估扩散加权成像（DWI）在鉴别乳腺良恶性病变中的诊断效能。

方法

2012年6月至2013年3月期间，我们纳入了60例患有63个病变的患者（年龄范围29 - 70岁，平均年龄48.6岁）。除复杂囊肿和乳腺内淋巴结外，所有病变均经组织病理学证实。使用专用双侧乳腺线圈，通过1.5特斯拉磁共振扫描仪对患者进行评估。通过回波平面成像序列获取DWI图像，“b”值选择为200、600和1000 s/mm²。计算双侧乳腺病变及对侧乳腺正常纤维腺组织的表观扩散系数（ADC）值，并使用Shapiro-Wilk检验、Student's t检验、Mann-Whitney U检验、卡方检验和受试者工作特征曲线进行统计学比较。

结果

63个病变中，22个为恶性，41个为良性。在恶性病变中，b = 200时平均ADC值为1.40±0.41×10⁻³mm²/s，b = 600时为1.05±0.28×10⁻³mm²/s，b = 1000时为0.91±0.20×10⁻³mm²/s；在良性病变中，b = 200时平均ADC值为2.13±0.85×10⁻³mm²/s，b = 600时为1.64±0.47×10⁻³mm²/s，b = 1000时为1.40±0.43×10⁻³mm²/s。ADC值在鉴别良恶性病变方面的成功率具有统计学意义（P = 0.0001）。确定b = 200时阈值为1.50×10⁻³mm²/s，b = 600时为1.22×10⁻³mm²/s，b = 1000时为0.98×10⁻³mm²/s（P < 0.05）。