磁共振扩散加权成像联合动态增强评估乳腺导管内癌与乳腺浸润癌的比较研究

目的：探讨乳腺导管内癌（DCIS）与浸润癌（IC）在动态增强磁共振成像（DCE-MRI）和扩散加权成像（DWI）上的影像特征，提高其影像诊断水平。方法回顾性分析10例DCIS患者（病灶13个）及10例 IC患者（病灶10个）的DCE-M RI及DWI图像，分析病灶强化形态特征、时间信号强度曲线并定量分析 ADC值。结果依据强化形态特征：DCIS强化以非块样强化中的段样强化为主，IC强化以块样强化为主，两者间差异具有统计学意义。依据时间信号强度曲线：DCIS和IC均以流出型为主，无显著性差异。依据ADC值：DCIS的平均ADC值约为（1．036±0．25）×10^-3 mm^2/s ， IC的平均ADC值约为（0．79±0．20）×10^-3 mm^2/s ，两者间差异具有统计学意义。结论结合病灶强化形态特征及ADC值，DCE-M RI联合DWI有助于乳腺导管内癌及浸润癌的鉴别诊断，提高影像诊断水平。

Comparative study of MR diffusion weighted imaging and dynamic contrast enhanced magnetic resonance imaging in assessment on breast ductal carcinoma in situ and invasive ductal carcinoma

Objective To explore image features of the breast ductal carcinoma in situ （DCIS） and invasive carcinoma （IC） in dynamic contrast enhanced magnetic resonance imaging （DCE-MRI） and diffusion weighted imaging （DWI） for improving the accuracy of diagnostic imaging .Methods We retrospectively analysed 10 cases of DCIS patients （13 lesions） and 10 IC patients （10 lesions） on DCE-MRI and DWI images ,and assessed enhanced pattern features ,time signal intensity curve ,and ADC value of each lesion .Results According to enhanced pattern features of the lesion ,segment enhancement of non blocking enhancement in DCIS and blocking enhancement in IC had statistically significant differences .According to time signal intensity curve ,both DCIS and IC were dominated by outflow type .without no significant difference .According to the ADC values of lesions ,the average ADC value of DCIS was （1 .036 ± 0 .25） × 10^-3 mm^2/s ,the aver-age ADC value of IC was （0 .79 ± 0 .20）× 10^-3 mm^2/s .The average ADC value in DCIS and IC lesions had statistically significant difference .Conclusion According to enhanced pattern features and the ADC value of lesions ,the combination of DCE-MRI and DWI is useful to differentiate ductal carcinoma in situ and invasive carcinoma for improving the accuracy of dianostic imaging .