Diffusion-weighted MR imaging of the breast:Comparison of apparent diffusion coefficient values of normal breast tissue with benign and malignant breast lesions,乳房MR扩散加权成像：比较正常乳腺组织与良性和恶性乳腺病变表观扩散系数值 XIA WANJUN,The specificity of conventional magnetic resonance (MR) imaging is lower than its high sensitivity. 传统的磁共振（MR）成像灵敏度低。 Diffusion-weighted imaging (DWI), based on alterations in the microscopic motion of water molecules, promises improved specificity for breast MR imaging.In this study, we aimed to determine the diagnostic potential of DWI to differentiate between benign and malignant breast lesions and normal breast tissue.弥散加权成像（DWI）的基础是水分子的微观运动，是特殊的乳腺磁共振成像技术。本项研究的目的是探讨DWI对区分良性和恶性乳腺病变及正常乳腺组织的潜在诊断性。,Dynamic contrast-enhanced breast MR imaging and DWI were applied to 108 women. Apparent diffusion coefficient (ADC) values were obtained for normal breast tissue (n = 183), benign lesions (n = 66) and malignant lesions (n = 58). The results were compared with the patients final diagnoses. 对108名妇女进行动态对比增强乳腺磁共振成像和弥散加权成像。对正常乳腺组织（N= 183例），良性病变组（n =66例），恶性病变 （N =58例）分别进行表观扩散系数（ADC）值测定。然后与患者的最终诊断结果进行比较。,The mean age of the patients was 44.9 (range 1977) years. There was no difference between the mean age of patients with malignant and benign lesions (45.0 years vs. 44.8 years, p = 0.9;Students t-test). The ADC measurements of normal breast tissue were obtained from 183 breasts. 患者的平均年龄为44.9岁（范围19-77）。恶性和良性患者的平均年龄之间无显着差异（45.0岁vs44.8年，P = 0.9;t分布检验 ）。正常乳腺组织的ADC测量有183例。,On histopathological examination, 58 lesions proved to be malignant in 42 patients: invasive ductal carcinoma (IDC) n = 31; invasive lobular carcinoma (ILC) n = 1; mixed invasive lobular and ductal carcinoma (IDC+ILC) n = 3; ductal carcinoma in situ n = 2; mix IDC + mucinous carcinoma n = 1;IDC and pleomorphic carcinoman = 1; medullary carcinoma n = 1; 对42位患者58例病变进行病理组织学检查，发现恶性乳腺浸润性导管癌（IDC）31位患者，浸润性小叶癌（ILC）1位患者，浸润性导管癌和浸润性小叶癌（IDC+ ILC）3位患者;导管原位癌2位患者;浸润性导管癌+黏液腺癌 1位患者;浸润性导管癌和多形性癌1例，髓样癌1位患者，,malignant phyllodes tumour n = 1; diffuse leukaemic infiltration of the breast n = 1 . 恶性叶状肿瘤1位患者，弥漫性白血病浸润乳腺1位患者。 The mean size of the malignant lesions was 41.3 34.3 mm. 恶性病变的平均大小为41.334.3毫米。 A total of 66 benign lesions in 44 patients were included in the study. 44位患者66例良性病变的研究。,35 lesions were histopathologically diagnosed as benign fibroadenoma (n = 18) , cystosarcoma phyllodes tumour (n = 2), fibrocystic changes (n = 4), seroma (n = 6), fat necrosis (n = 2), ductal hyperplasia (n = 1), papilloma (n = 1) and haematoma (n = 1). 35例病变组织病理学诊断为良性纤维腺瘤18例，分叶状囊肉瘤2例，纤维囊性变4例，血清肿组6例，脂肪坏死2例，导管上皮增生1例，乳头状瘤1例和血肿1例。,31 benign lesions had typical BI-RADS (Breast Imaging Reporting and Data System) 2 findings on DCE-MRI and were diagnosed as cyst (n = 7), fibroadenoma (n = 20) and intramammarian lymph node (n = 4) . DCE-MRI检查对31例典型的良性病变定BI-RADS分级（乳腺影像报告和数据系统）2 ，并诊断为囊肿7例，纤维腺瘤20例和乳房淋巴结4例。,Resu lts：Mean ADC values for benign and malignant breast lesions were 1.04 103 0.29 103 mm2/s and 2.00 103 0.55 103 mm2/s, respectively (p = 0.001, Students t-test), while that for normal breast tissue was 1.78 103 0.33 103 mm2/s. With a cut-off value of 1.46 103 mm2/s for ADC in receiver operating characteristic analysis,95% sensitivity and 85% specificity were achieved for differentiating between benign and malignant lesions. 结果 乳腺良、恶性病变的ADC值平均值分别为1.0410-30.29103mm2/s和2.001030.5510-3 mm2/s，（P = 0.001，t分布检验），而正常乳腺组织1.781030.33103 mm2/s。根据受试者特征取1.46103 mm2/s的ADC为区分良性和恶性病变的临界值，得到敏感性为95和特异性85。,Conclusion DWI of the breast can help differentiate benign and malignant breast lesions from normal breast tissue. 结论 乳房DWI检查可以帮助区分良性、恶性乳腺病变与正常乳腺组织。 DWI, which can be easily introduced into standard breast MR imaging protocols without increasing imaging times,promises to increase the accuracy of breast MR imaging without contrast media. 。 DWI在不增加成像时间，通常作为常规的乳房MR成像检查方法之一，增加乳腺磁共振成像的准确性而无需造影剂。,Since the specificity of conventional MR imaging, which uses morphological and kinetic criteria, is relatively lower than its high sensitivity, advanced MR imaging application has a potential role to play in the diagnosis of breast lesions. 常规磁共振成像，它采用形态学和动力学的标准，其灵敏度低于相对先进的磁共振成像，先进的磁共振成像技术在乳腺病变的诊断中具有潜在的作用。 Diffusion-weighted imaging (DWI) promises improved specificity of breast MR imaging.弥散加权成像（DWI）能够提高乳腺磁共振成像的特异性。,DWI is an advanced MR imaging technique based on the diffusion signal of tissues, which reflects the amount of random motion of water molecules into tissues due to thermal agitation (Brownian motion). DWI是一种先进的磁共振成像技术，基于组织的扩散信号，反映了组织中水分子的随机热运动（布朗运动）。 DWI was first introduced for acute cerebral infarction, for which it has become one of the primary imaging modalities. DWI最初引入急性脑梗塞，并已成为主要成像方式之一。,However, it is now being used for other clinical applications over the entire body, and holds great promise for the detection and characterisation of tumours of other organs such as the ovaries, pancreas, prostate and breast. 然而，现在被用于整个身体部位的临床检查，它在检测卵巢，胰腺，前列腺癌和乳腺肿瘤及描述肿瘤征象方面