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乳腺良性病变磁共振扩散加权成像表现规律探讨
作者:曾晓英  
单位:东南大学
关键词:乳腺 良性病变  磁共振成像 扩散加权成像 表观扩散系数  
分类号:
出版年·卷·期(页码):2010·38·第三期(216-220)
摘要:

目的 探讨磁共振扩散加权成像( diffusion-weighted imaging, DWI)及其表观扩散系数(apparent diffusion coefficient ,ADC)在乳腺良性疾病诊断中的价值及不同乳腺良性病变DWI表现规律。 方法 收集患者109例, 115个良性病灶,纤维腺瘤41个,囊肿28个,乳腺病26个,慢性炎症5个,导管内乳头状瘤2,错构瘤2个,结核2个,脂肪瘤9个,所有病灶均经手术病理证实。DWI扫描采用b=400-0,800-0,1000-0s/mm 2,计算ADC值;计数病灶随b值增大其信号强度及面积变化规律;计数病灶DWI信号表现。结果 乳腺纤维腺瘤、囊肿、乳腺病、慢性炎症与正常腺体间ADC值差异均具有统计学意义;囊性病与非囊性病之间ADC值差异有统计学意义;但非囊性病变之间ADC值差异不具有统计学意义;囊性病变在3个b值下的ADC值差异不具有统计学意义;但是非囊性病变在3个b值下的ADC值差异具有统计学意义,且b值越低,ADC值越大。大部分乳腺良性病灶随着b值的增大DWI 信号强度及面积逐渐减低。除9例脂肪瘤均为低信号外,乳腺良性病变表现为不同程度的高信号、等信号或混杂信号。结论 ADC值有助于乳腺良性病变中囊性病变及非囊性病变的鉴别诊断;乳腺良性肿块随b值的增大,其DWI信号强度及面积大小表现有差异的规律性,有助于定性诊断。

Objective To investigate the value of apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance imaging (DW-MRI) in patients wtih breast benign lesions Methods 109 patients, 115 benign lesions,41 fibroadenoma,28 cysts,26 adenosis,5 mastitis,2 intraductal papillomas,2 hamartomas, 2 tuberculosis,9 lipoma. All cases were pathologically confirmed.All patients were scan with 3 b values (b=400-0,800-0,1000-0s/mm 2) in DWI.Then the ADC value and the area of and the singnal intensity and the findings of lesions in DWI were calculated.Results All lesions have significant differences between the ADC values of fibroadenomas, cysts, ndenosis,as well as mastitis and normal breast tissue respectively;There were significant differences between the ADC values of cystic diseases and non- cystic lesions; There were no significant differences among the ADC values of fibroadenoma, ndenosis and mastitis.There were no differences among ADC values in cystic diseases during 3 b value .But there were significant differences among ADC values in non- cystic diseases during 3 b value. And the lower the b value,the higher the ADC;The singal intensity and area of the most of benign lump are decrease with the b valuec increasing. Except 9 lipomas ,all the benign lesions manifest hyper-singnal intensity or iso-singnal intensity or mixture intesity. Conclusion ADC value may help to differentiate cystic diseases and non- cystic diseases; The signal intensity and area of benign lump in DWI show discrepant regularity with b value increasing. It can be used to differenciate diagnosis.

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