标题：磁共振扩散加权成像联合动态增强对乳腺微小肿块的诊断价值

      作者：黄正旺，王岩，苏仕炜，郑晓昀，王文新，常莎    (广东同江医院放射科，广东 佛山 528300)

      卷次： 2017年28卷14期

      【摘要】 目的 观察磁共振扩散加权成像联合动态增强在乳腺微小肿块中的应用价值。方法 回顾性分析2013年8月至2016年6月广东同江医院诊治的乳腺微小肿块患者73例，其中37例为良性病灶，42例为恶性病灶，患者均行扩散加权成像联合动态增强检查，观察微小肿块的病变形态、边缘、曲线类型，分析扩散加权成像联合动态增强在乳腺微小肿块中的诊断价值。结果 以形态为标准，其灵敏度、特异度、准确度、阴性似然比、阳性似然比分别为 85.7% (36/42)、54.1% (20/37)、70.9% (56/79)、0.264、1.867；以ADC为标准，乳腺微小肿块诊断灵敏度、特异度、准确度、阴性似然比、阳性似然比分别为 83.3% (35/42)、83.8% (31/37)、83.5% (66/79)、0.199、5.142；扩散加权成像联合动态增强诊断灵敏度低于Fisher评分，高于ADC评分，差异有统计学意义(P<0.05)；扩散加权成像联合动态增强诊断特异度、准确度显著高于Fisher评分和ADC评分，差异有统计学意义(P<0.05)。结论 乳腺微小肿块患者采用扩散加权成像联合动态增强诊断效果理想，具有较高的特异度、准确度，为后续治疗提供影像学依据。
      【关键词】 扩散加权成像；动态增强；乳腺微小肿块；应用
      【中图分类号】 R655.8 【文献标识码】 A 【文章编号】 1003—6350（2017）14—2315—04

Diagnostic value of magnetic resonance diffusion-weighted imaging combined with dynamic enhancement inbreast masses.
HUANG Zheng-wang, WANG Yan, SU Shi-wei, ZHENG Xiao-yun, WANG Wen-xin, CHANG Sha.Department of Radiology, Tongjiang Hospital of Guangdong, Foshan 528300, Guangdong, CHINA
【Abstract】 Objective To observe the value of magnetic resonance diffusion-weighted imaging combined withdynamic enhancement in breast tumor. Methods A retrospective study was conducted in 73 patients with breast cancerfrom August 2013 to June 2016, including 37 cases of benign lesions and 42 cases of malignant lesions. All the patientswere treated with diffusion-weighted imaging combined with dynamic enhancement. The morphological, marginal, andcurve types of the lesion were observed, and the value of diffusion-weighted imaging combined with dynamic enhance-ment in the diagnosis of breast masses was analyzed. Results The sensitivity, specificity, accuracy, negative likelihoodratio, positive likelihood ratio was 85.7% (36/42), 54.1% (20/37), 70.9% (56/79), 0.264, 1.867 using morphology as stan-dard, and 83.3% (35/42), 83.8% (31/37), 83.5% (66/79), 0.199, 5.142 using ADC as standard (P<0.05). The sensitivity ofdiffusion-weighted imaging combined with dynamic enhancement was significantly lower than Fisher's score but higherthan ADC score (P<0.05). The diagnostic specificity and accuracy diffusion-weighted imaging combined with dynamicenhancement was significantly higher than Fisher's score and ADC score (P<0.05). Conclusion Diffusion-weighted im-aging combined with dynamic enhancement is ideal for patients with small breast masses. It has high specificity and ac-curacy, and provides imaging basis for follow-up therapy.
      【Key words】 Diffusion-weighted imaging; Dynamic enhancement; Small breast masses; Value·论 著·doi:10.3969/j.issn.1003-6350.2017.14.024