本文選題：乳腺腫瘤　切入點(diǎn)：擴(kuò)散磁共振成像　出處：《中國(guó)醫(yī)學(xué)影像技術(shù)》2015年07期

【摘要】：目的應(yīng)用體素內(nèi)不相干運(yùn)動(dòng)(IVIM)雙指數(shù)模型探討真性彌散系數(shù)(D)、與灌注相關(guān)的假性彌散系數(shù)(D*),灌注分?jǐn)?shù)(f)在診斷乳腺腫塊樣病變?cè)\斷中的應(yīng)用價(jià)值。方法收集經(jīng)病理證實(shí)的乳腺惡性腫塊48例(惡性組)、良性腫塊26例(良性組)及正常體檢者19名(對(duì)照組),均行常規(guī)MRI檢查及多b值的彌散加權(quán)成像檢查。比較3組間D值、f值、D*值及ADC值的差異,采用ROC曲線評(píng)估各個(gè)指標(biāo)對(duì)乳腺良惡性腫塊樣病變的診斷效能。結(jié)果對(duì)照組、良性組及惡性組間D、f、D*及ADC值的差異均有統(tǒng)計(jì)學(xué)意義(P均0.01)。良性組D值低于對(duì)照組、且高于惡性組(P均0.01);惡性組f值高于對(duì)照組及良性組(P均0.01),而對(duì)照組與良性組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.14);良性組D*值低于對(duì)照組、高于惡性組(P均0.01);良性組ADC值低于對(duì)照組、高于惡性組(P均0.01)。惡性組的D值顯著低于ADC值(P0.01)。分析采用各DWI參數(shù)鑒別診斷乳腺惡性腫塊樣變的ROC曲線,D值具有較高的診斷效能,其次依次為ADC值,f值及D*值,曲線下面積(AUC)依次為0.95、0.90、0.87、0.75。結(jié)論 IVIM雙指數(shù)模型能夠真實(shí)反映乳腺腫塊樣病變水分子的彌散情況,尤其是D值對(duì)乳腺病變良惡性的鑒別診斷具有重要的參考意義。
[Abstract]:Objective to investigate the diagnostic value of true diffusion coefficient (DG), pseudo-diffusive coefficient (PSD) and perfusion fraction (F) in diagnosis of breast tumor-like lesions by using the IVIM-VIVIMM model. Methods the clinical data of dysmenorrhea were collected. 48 cases of malignant breast masses (malignant group, 26 cases of benign mass) and 19 cases of normal physical examination (control group) were examined by conventional MRI and diffusion-weighted imaging with multiple b values. The difference between the value of D * and the value of ADC, ROC curve was used to evaluate the diagnostic efficacy of each index for benign and malignant breast tumor-like lesions. Results there were significant differences in D * and ADC values among the control group, benign group and malignant group (P < 0.01). The D value of benign group was lower than that of control group. The F value of the malignant group was higher than that of the control group and the benign group, but there was no significant difference between the control group and the benign group, the D * value of the benign group was lower than that of the control group and higher than that of the malignant group, and the ADC value of the benign group was lower than that of the control group. The D value of malignant group was significantly lower than that of ADC value (P 0.01). The value of ROC curve D in differential diagnosis of malignant breast mass by DWI parameters was higher than that in malignant tumor group (P < 0.01), followed by ADC value F value and D * value, and the value of D value was higher than that of malignant tumor group (P < 0.01), and the D value of malignant group was significantly lower than that of ADC value (P < 0.01). The area under the curve is 0.950.90 / 0.870.75.Conclusion the IVIM double index model can truly reflect the diffusion of water molecules in breast tumor-like lesions, especially the D value is of great significance for the differential diagnosis of benign and malignant breast lesions.
【作者單位】： 南方醫(yī)科大學(xué)附屬深圳市婦幼保健院放射科;深圳市第二人民醫(yī)院介入治療科;北京大學(xué)深圳醫(yī)院醫(yī)學(xué)影像中心;
【分類號(hào)】：R445.2;R737.9

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