3.0T磁共振扩散加权成像在乳腺癌诊断及病理分型中的应用价值

目的探讨3.0T磁共振扩散加权成像（DWI）在乳腺癌诊断中的应用价值，并分析表观弥散系数（ADC）对乳腺癌病理分型的意义。 方法回顾性分析2017年9月至2018年9月牡丹江医学院附属红旗医院收治的经手术或穿刺活检病理证实的72例乳腺癌患者。比较MR平扫、DWI及两者联合诊断乳腺癌的准确性；比较b值为1000 s/mm²时不同病理类型乳腺癌ADC值的差异。 结果本组72例乳腺癌患者，病理证实非浸润性癌19例（导管内原位癌17例，小叶原位癌2例）；浸润性癌53例（浸润性导管癌42例，浸润性小叶癌11例）。MR平扫、DWI及两者联合诊断本组72例乳腺癌患者的准确率分别为88.9%（64/72）、65.3%（47/72）、95.8%（69/72）。b值为1000 s/mm²时，导管内原位癌与浸润性导管癌、小叶原位癌与浸润性小叶癌平均ADC值差异均有统计学意义（t=0.015，P<0.001；t=3.095，P<0.05）。 结论DWI对乳腺癌的诊断有一定的临床价值，MR平扫与DWI两者联合对乳腺癌诊断具有较高的准确性。ADC值对乳腺浸润性癌与非浸润性癌的区分有价值。

Application value of 3.0T magnetic resonance diffusion weighted imaging in the diagnosis and pathological classification of breast cancer

ObjectiveTo explore the application value of 3.0T magnetic resonance (MR) diffusion weighted imaging (DWI) in the diagnosis of breast cancer, and to analyze the significance of apparent dispersion coefficient (ADC) in the pathological classification of breast cancer. MethodsA total of 72 patients with breast cancer pathologically confirmed by surgery or puncture biopsy were analyzed retrospectively in Hongqi Hospital of Mudanjiang Medical College from September 2017 to September 2018. The accuracy of MR plain scan, DWI and the combination of the two for the diagnosis of breast cancer was compared. When the b value was selected as 1000 s/mm², the difference in ADC value of different pathological types of breast cancer was compared. ResultsIn this group of 72 breast cancer patients, 19 cases were pathologically confirmed as non-invasive carcinoma (17 cases of inductal carcinoma in situ, 2 cases of lobular carcinoma in situ), 53 cases of invasive carcinoma (42 cases of invasive ductal carcinoma and 11 cases of invasive lobular carcinoma). The diagnostic accuracy of 72 breast cancer patients with MR plain scan, DWI and the combination of the two was 88.9%(64/72), 65.3%(47/72) and 95.8%(69/72), respectively. When the b value was 1000 s/mm², the difference of ADC value between invasive breast cancer and non-invasive cancer was statistically significant (P<0.05). ConclusionsDWI has certain clinical value in the diagnosis of breast cancer. The combination of MR plain scan and DWI has a high accuracy in the diagnosis of breast cancer. ADC values are valuable for the differentiation of invasive and non-invasive breast cancer.