【摘要】：目的探討動態(tài)增強磁共振成像(DCE-MRI)聯(lián)合擴散加權(quán)成像(DWI)對乳腺導管原位癌(DCIS)和腺病的診斷價值。方法搜集74例經(jīng)病理證實的乳腺疾病患者的MRI資料,其中DCIS 38例、腺病36例,術(shù)前均行DCE-MRI及DWI。統(tǒng)計病灶的形態(tài)學特征、時間-信號強度曲線(TIC)及表觀擴散系數(shù)(ADC)值,并運用χ2檢驗和t檢驗分析DCIS和腺病組差異;采用受試者工作特征曲線(ROC)確定DCIS和腺病的ADC界值。結(jié)果 DCIS和腺病均以非腫塊樣強化多見(96.8%,94.4%),前者以導管樣、節(jié)段樣強化為主(22/38,57.8%),后者以區(qū)域性、彌漫性強化為主(20/36,55.5%);DCIS以均勻強化多見(15/38,39.5%),而以點簇樣強化更具特征性。乳腺腺病多表現(xiàn)為不均勻強化(21/36,58.3%),且強化方式多變;Ⅰ型TIC多見于乳腺腺病(18/36,50%),而Ⅲ型曲線多見于DCIS(13/38,34.2%),Ⅱ型曲線在兩者之間無顯著差異。DCIS的ADC值(1.048±0.163)×10~(-3)mm~2/s顯著低于乳腺腺病ADC值(1.521±0.323)×10~(-3)mm~2/s(b=800 s/mm~2),差異具有統(tǒng)計學意義(P0.0001)。根據(jù)ROC曲線確定ADC界值為1.30×10~(-3)mm~2/s,診斷敏感性和特異性分別為79.8%、81.8%(b=800 s/mm~2)。結(jié)論DCE-MRI有助于鑒別DCIS和乳腺腺病,聯(lián)合DWI能夠提高診斷效能。
[Abstract]:Objective to evaluate the diagnostic value of dynamic enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion weighted imaging (DWI) in the diagnosis of ductal carcinoma in situ (DCI) and adenopathy. Methods MRI data of 74 patients with breast disease confirmed by pathology were collected, including 38 cases of DCIS and 36 cases of adenosis. DCE-MRI and DWI. were performed before operation. The morphological characteristics, time-signal intensity curve (TIC) and apparent diffusion coefficient (ADC) of the lesions were analyzed. The difference between DCIS and adenosis was analyzed by 蠂 2 test and t test. The ADC bounds of DCIS and adenosis were determined by using the operating characteristic curve (ROC) of the subjects. Results Non-tumor-like enhancement was more common in DCIS and adenosis (96.80.94%), the former was catheter-like and segmental enhancement (22 / 38-57.8%), the latter was regional and diffuse (20 / 36,55.5%). Uniform enhancement was more common in DCIS (15 / 38%, 39.5%), while cluster enhancement was more characteristic. Most of the adenosis of mammary gland showed uneven enhancement (21 / 36) (58.3%), and the pattern of enhancement was varied. Type I TIC was more commonly seen in adenosis of the breast (18 / 36 / 50%), while type 鈪，

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