计算弥散加权成像在乳腺癌诊断中的应用

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摘要目的：定量比较3.0T磁共振系列计算弥散加权成像（cDWI）和常规扫描弥散加权成像（mDWI）对乳腺癌的显示能力。方法：收集温州医科大学附属第一医院2012年1月至2015年12月间经手术病理证实为乳腺癌且术前有多参数乳腺成像数据的病例，共24例，均为女性，年龄25～63岁，平均（48±10）岁。据低b值（b=0、1 000 s/mm2）mDWI图像经MATLAB 2015b环境下编程，单指数模型拟合重建系列b值（b=1 000、1 500、2 000、2 500、3 000、3 500、4 000 s/mm2）cDWI图像，分别测量乳腺癌及正常腺体组织信号强度以及背景噪声，定量比较系列cDWI和mDWI1 000图像信噪比（SNR）和肿瘤与正常组织间对比信噪声比（CNR）。结果：乳腺癌cDWI图像SNR随b值增加进行性下降（H=134.985，P＜0.05），而CNR则缓慢升高（H=62.779，P＜0.05），cDWI1 000图像SNR值高于mDWI1 000（t=2.868，P＜0.05），CNR值则无明显差异（t=0.096，P＞0.05）；其余b值cDWI图像SNR均低于mDWI1 000（t=-7.766、-11.377、-12.259、-12.737、-12.869、-12.896，P＜0.01）；b值范围（b=1 500、2 000、2 500、3 000 s/mm2）cDWI图像CNR值高于mDWI1 000（t=3.138、3.263、2.855、2.243，P＜0.05），更高b值cDWI图像CNR值与mDWI1 000比较差异无统计学意义（t=2.066、1.839，P＞0.05）。结论：高b值cDWI图像有助于乳腺癌组织显示，是常规乳腺多参数扫描序列的有益补充

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关键词 ：乳腺肿瘤, 磁共振成像, 计算弥散加权成像

Abstract：Objective: To quantitatively compare the signal-to-noise (SNR) and the contrast-to-noise ratio (CNR) between series computed diffusion-weighted images (cDWI) and directly measured diffusion-weighted images (mDWI) with b value of 1 000 s/mm2 in patients with breast cancer using 3.0T MRI, and to obtain optimized b value cDWI images with diagnostic quality. Methods: Twenty-four patients with breast cancer (female, age ranged 25-63 years) received DWI examinations at 3.0T (b values of 0, 1 000 s/mm2) to create cDWI images at arbitrary b values of 1 000, 1 500, 2 000, 2 500, 3 000, 3 500, 4 000 s/mm2 under MATLAB 2015b environment. Regions of interest (ROI) were drawn on tumor-suspicious lesions and normal-appearing regions. Results: The CNR between tumor and normal regions in cDWI showed a continuously improvement with increasing b value (H=62.779, P<0.05), but the SNR was progressively decreased (H=134.985, P<0.05). cDWI1 000 and mDWI1 000 showed a similar CNR (t=0.096, P>0.05), but SNR of cDWI1 000 was higher than that of mDWI1 000 (t= 2.868, P<0.05). SNR of the remaining b value cDWI were lower than mDWI1 000 (t=-7.766, -11.377, -12.259, -12.737, -12.869, -12.896, all P<0.01). CNR of b value range (b=1 500, 2 000, 2 500, 3 000 s/mm2) cDWI were higher than those of mDWI1 000 (t=3.138, 3.263, 2.855, 2.243, P<0.05), but the difference of CNR between higher b value cDWI and mDWI1 000 was not significant (t=2.066, 1.839, P>0.05). Conclusion: The high b-value cDWI images contributes to visualize the breast cancer, and the optimal b value cDWI for breast cancer detection is in the range of 1 500-2 000 s/mm2.

Key words： breast neoplasms magnetic resonance imaging compute diffusion-weighted imaging

收稿日期: 2016-10-07

基金资助:浙江省自然科学基金资助项目（LQ4H180006）。

通讯作者: 叶琼，副研究员，Email：94301699@qq.com

作者简介: 许化致（1977-），男，浙江苍南人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I7/485

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