乳腺癌癌周间质的动态增强MRI及扩散加权成像  

Researsh on the stroma around breast cancer by dynamic contrast enhanced MRI and diffusion-weighted imaging

作　　者：李志宇[1] 何之彦[1] 李康安[1] 王建丰[2] 路光中[3] 

机构地区：[1]上海交通大学医学院附属第一人民医院放射科,上海200080 [2]上海交通大学医学院附属第一人民医院甲乳外科,上海200080 [3]上海交通大学医学院附属第一人民医院病理科,上海200080

出　　处：《放射学实践》2014年第10期1132-1136,共5页Radiologic Practice

摘　　要：目的:研究磁共振动态增强及扩散加权成像上乳腺癌癌周间质的影像学表现,并探讨其对确定乳腺癌肿瘤边界的价值。方法:搜集2012年10月-2014年3月行乳腺MRI检查,手术或穿刺活检病理证实为乳腺癌的患者共31例(所选病例均为单侧单中心发病)。测量乳腺癌病灶与病灶周围组织不同方向上的表观扩散系数(ADC)值及信号增强率(SER),并进行统计学分析。结果:横轴面DWI图像:乳腺癌病灶内的ADC值显著低于病灶周围组织;乳腺癌周围组织同一层面不同方向的ADC值之间差异无统计学意义(P>0.05);但对于同一方向上的不同层面,靠近病灶的第1层(范围约5mm)的ADC值小于远离它的3个层面(P<0.05);乳腺癌、癌旁组织、正常侧乳腺组织的平均ADC值之间差异具有统计学意义(F=32.496,P=0.000)。横轴面动态增强图像:乳腺癌病灶内的SER显著高于病灶周围组织;但病灶周围组织各层面之间SER的差别无统计学意义(P>0.05);病灶周围组织同一层面的不同方向的SER之间差异无统计学意义(P>0.05)。结论:MR动态增强的SER及DWI成像的ADC值对乳腺癌与癌周间质组织的判别有一定的敏感性和特异性,有望成为确定乳腺癌范围及手术切缘的有效影像学方法。Objective：To evaluate tumor margin by dynamic contrast enhanced MRI and diffusion-weighted imaging in breast cancer.Methods：The study included 31 cases of breast cancer which were examined with dynamic contrast enhanced MRI and diffusion-weighted imaging （DWI）before operation in our hospital performed from June 2012 to March 2014.The ADC and signal enhancement ratio （SER）values of the tumor tissue and breast stroma beyond the tumor margin were measured and analyzed statistically.Results：The ADC value of breast cancer was significantly lower than that of the stroma beyond the tumor margin.There was no statistically different in ADC values among different directions （anterior,posterior, left and right）within the same slice （P 〉0.05）.However,there was a statistically significant difference among the ADC values in the tissue of the first slice adjacent to tumor and in the tissues of other three slices away from tumor （P 〈0.05）. The SER value in the tissue of breast cancer was significantly higher than that of the stroma beyond the tumor margin. There was no statistically significant difference in SER values among different directions （anterior,posterior,left and right） within the same slice （P 〉0.05）.Conclusion：ADC and SER values were sensitive and specific parameters that could help differentiate malignant breast lesions and normal tissue.They could be regarded as promising methods for helping determine surgical scope and margin of breast carcinoma in the future.

关 键 词：乳腺肿瘤 扩散磁共振成像 诊断 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]