3.0T磁共振动态增强、扩散加权成像对乳腺癌的诊断价值与病理学对照研究

目的:结合病理结果探讨3.0T磁共振动态增强、扩散加权成像对乳腺癌的诊断价值。方法:结合手术或穿刺活检病理结果回顾性分析53例乳腺癌患者及34例乳腺良性疾病患者的3.0 T磁共振成像图像。评估两组病灶的形态学征象、动态增强表现、及扩散加权成像表现,并作统计学分析。形态学征象包括:病灶的形状和边缘、病灶周围组织水肿、皮肤增厚、乳头受累、及腋窝淋巴结肿大等;动态增强包括病灶强化特征及时间-信号强度曲线(time-signal intensity curve,TIC)表现;扩散加权成像(diffusion-weighted imaging,DWI)包括良恶性病灶的ADC值,对侧正常组织的ADC值,及相对ADC(relative ADC,r ADC)值。结果:乳腺癌患者组与乳腺良性疾病患者组形状及边缘等征象存在统计学差异,病灶周围水肿、皮肤增厚、乳头受累、腋窝淋巴结肿大等征象无统计学差异。乳腺癌患者组与乳腺良性疾病患者组的强化方式及TIC分型存在统计学差异。乳腺癌患者组与乳腺良性疾病患者组DWI信号表现无统计学差异。乳腺癌患者组病灶侧ADC值为(1.042±0.019)×10-3mm2/s],对侧正常组织的ADC值为(1.812±0.017)×10-3mm2/s],病灶与对侧正常组织的ADC值比较差异有统计学意义;乳腺良性疾病患者组病灶侧ADC值为(1.558±0.022)×10-3mm2/s],对侧正常组织的ADC值为(1.806±0.018)×10-3mm2/s],病灶与对侧正常组织的ADC值比较差异有统计学意义;良恶性组病灶侧ADC值组间差异有统计学意义。良恶性组对侧正常组织间的ADC值组间差异无统计学意义。良恶性组相对ADC(r ADC)值分别为(0.865±0.014)、(0.580±0.013),组间差异有统计学意义。结论:良恶性肿瘤的MRI的形态学征象有一定重叠,动态增强扫描及扩散加权成像的定量参数有助于鉴别乳腺良恶性肿瘤。

The value of 3.0T MRI DCE-MRI and DWI for the diagnosis of breast cancer combined with histopathology

Objective:To investigate the value of 3.0T MRI dynamic contrast enhanced imaging (DCE-MRI) and diffusion-weighted imaging (DWI) for the diagnosis of breast cancer combined with histopathology.Methods:3.0T MRI data of 53 patients with breast cancer and 34 patients with benign tumor were reviewed;all of patients were confirmed with surgery or biopsy and histopathology.Morphological feature,MRI dynamic contrast enhanced imaging (DCE-MRI),and diffusion-weighted imaging (DWI) manifestation of the lesions were evaluated and statistical difference was compared between breast cancer and benign tumor.Morphological feature included configuration,edge,peri-focal edema,skin thickening,nipple involvement and axillary lymph nodes enlargement.MRI dynamic contrast enhanced imaging (DCE-MRI) included lesion enhancement features and time-signal intensity curve (TIC) performance.DWI included ADC value of benign or malignant lesions,ADC value of the contralateral normal tissue,and relative ADC (rADC) value.Results:There were significant statistical differences among configuration,edge between breast cancer and benign tumor,respectively.No statistical differences could be found among peri-focal edema,spiculated sign,skin thickening,nipple involvement and axillary lymph nodes enlargement.There were significant statistical differences among lesion enhancement features,TIC performance between breast cancer and benign tumor,respectively.No statistical differences could be found DWI signal performance.There were significant statistical differences among ADC value between breast cancer (1.042±0.019)×10-3mm2/s] and contralateral normal tissue (1.812±0.017)×10-3mm2/s].There were significant statistical differences among ADC value between benign tumor (1.558±0.022)×10-3mm2/s] and contralateral normal tissue (1.806±0.018)×10-3mm2/s].There were significant statistical differences among ADC value between breast cancer (1.042±0.019)×10-3mm2/s] and benign tumor (1.558±0.022)×10-3mm2/s].No statistical differences could be found the ADC value of the contralateral normal tissue.There were significant statistical differences among relative ADC (rADC) between breast cancer (0.865±0.014) and benign tumor (0.580±0.013).Conclusion:Benign and malignant tumors MRI morphological signs have some overlapping, dynamic enhancement scanning and DWI quantitative parameters can help identify breast tumors.