弥散加权成像和动态增强MRI在鉴别乳腺良恶性冲洗曲线病变中的作用。

Sehnaz Tezcan, Funda Ulu Ozturk, Nihal Uslu, Eda Yilmaz Akcay
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引用次数: 12

摘要

目的:本研究旨在评价动态对比增强MRI (DCE-MRI)和弥散加权成像(DWI)联合乳腺磁共振成像(MRI)方案对表现为冲洗曲线的强化病灶患者的诊断价值,并确定应用表观扩散系数(ADC)截止值是否可以提高乳腺MRI的诊断价值。方法:回顾性研究116例乳腺可疑病变116例,DCE-MRI显示洗脱曲线,行活检。评估DCE-MRI形态学特征及DWI ADC值。比较良、恶性病变的表观扩散系数值及形态学特征。计算DCE-MRI和联合MRI的诊断价值,包括DCE-MRI和DWI(应用ADC截止值)区分恶性病变和良性病变。结果:116例乳腺病变中,恶性79例,良性37例。恶性肿瘤的ADC值(中位数ADC为0.72 × 10-3 mm2/s)显著低于良性病变(中位数ADC为1.03 × 10-3 mm2/s;P < .000)。ADC截止值0.89 × 10-3 mm2/s的敏感性和特异性分别为92%和95%。单独动态增强MRI的敏感性为100%,特异性为59.4%。添加0.89 × 10-3 mm2/s的ADC截止值提供了100%的灵敏度和81%的特异性,可以在不遗漏任何恶性肿瘤的情况下阻止21.6%的良性病变的活检。结论:将ADC截止值应用于dce MRI,可提高乳腺MRI对出现冲洗曲线病变的诊断价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve.

Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI.

Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated.

Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 × 10-3 mm2/s) was significantly lower than that of benign lesions (median ADC, 1.03 × 10-3 mm2/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 × 10-3 mm2/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 × 10-3 mm2/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies.

Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.

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