| 韩娜娜,张文斌,张志杰,杜帅.拉伸指数模型DWI鉴别诊断乳腺良恶性病变[J].中国医学影像技术,2018,34(6):869~873 |
| 拉伸指数模型DWI鉴别诊断乳腺良恶性病变 |
| Stretched-exponential model of DWI in differentiating malignant and benign breast lesions |
| 投稿时间：2017-10-22 修订日期：2018-03-10 |
| DOI：10.13929/j.1003-3289.201710031 |
| 中文关键词: 乳腺肿瘤 拉伸指数模型 扩散磁共振成像 动态对比增强 |
| 英文关键词:Breast neoplasms Stretched-exponential model Diffusion magnetic resonance imaging Dynamic contrast-enhanced |
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| 中文摘要: |
| 目的 分析自发性气胸的胸膜窗MSCT和CT仿真内镜（CTVE）表现。方法 收集73例自发性气胸患者MSCT资料，以气囊为中心行薄层（层厚1 mm） MPR及CTVE重建，观察胸膜窗大小、位置、胸膜面缺损或龛影形态及其与胸腔的连通关系。结果 73例自发性气胸患者中，MSCT薄层重建图像检出15例患者27个胸膜窗；左侧11例，右侧4例；多见于肺尖（15/27，55.56%），其次为前胸壁（7/27，25.93%）和纵隔面（5/27，18.52%）；23个（23/27，85.19%）可显示胸膜窗与胸腔的连通关系。胸膜窗均表现为壁层胸膜局限性缺损伴气囊突出，呈类圆形、椭圆形、短柱状或曲棍球状；CTVE正面观呈类圆或椭圆形，19个胸膜窗可直视气囊底部，6个胸膜窗侧壁平坦呈坑道状，其余胸膜窗侧壁多呈洞穴状。结论 胸膜窗常表现为壁层胸膜面小憩室样改变，其发病可能与局部胸腔负压增高、胸膜损伤有关。 |
| 英文摘要: |
| Objective To investigate the value of stretched-exponential model of DWI in differential diagnosis of benign and malignant breast lesions. Methods Totally 58 patients with 63 breast lesions (33 benign, 30 malignant lesions) were enrolled. All the patients underwent multiple-b-value DWI and dynamic contrast enhancement MRI (DCE-MRI) scans. The values of ADC, DDC and water molecular diffusion heterogeneity index (α) were calculated, and the time-signal intensity curve (TIC) was obtained. All the parameters were compared between benign and malignant breast lesions. The diagnostic performance of different parameters was evaluated with ROC curve. Results ADC, DDC and α value of malignant lesions was (1.01±0.19)×10-3 mm2/s, (0.89±0.23)×10-3 mm2/s and 0.75±0.09, while of benign lesions was (1.41±0.27)×10-3 mm2/s, (1.49±0.29)×10-3 mm2/s and 0.87±0.07, respectively. All 3 parameters in malignant lesions were lower than those in benign lesions (all P<0.01). Taking 1.22×10-3 mm2/s as the optimal threshold, the area under the curve (AUC) of DDC was the largest as 0.958, and the corresponding diagnostic sensitivity and specificity was 96.67% and 81.82%, respectively. AUC value was 0.976 by combining DDC with TIC, and the corresponding diagnostic sensitivity and specificity was 93.33% and 93.94%, respectively. Conclusion The stretched-exponential model DWI can differentiate breast lesions, and diagnostic performance of combination of DDC and TIC is better than ADC or DCE. |
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