3.0TMR扩散加权成像与乳腺浸润性导管癌组织学分级相关性研究  

Correlation between MRI apparent diffusion coefficient and histological grade of breast invasive ductal carcinoma

作　　者：李万湖[1] 徐亮[1] 杨慧[1,2] 吴玉芬[1] 崔永春[1] 

机构地区：[1]山东省肿瘤医院磁共振室,山东济南250117 [2]济南大学.山东省医学科学院医学与生命科学学院,山东济南250200

出　　处：《中华肿瘤防治杂志》2015年第13期1028-1031,1036,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省医学科学院科技计划面上项目(2014-15)

摘　　要：目的分析3.0T磁共振扩散加权成像(diffusion weighted magnetic resonance imaging,DW-MRI)表观扩散系数(apparent diffusion coefficient,ADC)与乳腺浸润性导管癌(invasive ductal carcinoma,IDC)组织学分级的相关性。方法山东省肿瘤医院2012-06-01-2014-09-30经手术病理确诊的121例乳腺IDC患者,患者术前均行常规3.0T MRI和DW-MRI检查,分别测量不同分级乳腺癌病灶及对侧正常乳腺的ADC值进行比较。通过绘制ROC曲线,寻找鉴别IDC与对侧正常乳腺组织ADC值的最佳诊断界值。结果乳腺IDCⅠ级ADC值为(1.043±0.138)×10-3 mm2/s,Ⅱ级ADC值为(0.871±0.193)×10-3 mm2/s,Ⅲ级ADC值为(0.654±0.182)×10-3 mm2/s,两两比较各组间差异均有统计学意义,P值均<0.01;乳腺IDC ADC值与病理组织学分级呈负相关,r=-0.427,P<0.01。IDC ADC值为(0.864±0.205)×10-3 mm2/s,对侧正常乳腺组织ADC值为(1.653±0.328)×10-3 mm2/s,两者差异有统计学意义,P<0.01。鉴别IDC和对侧正常乳腺组织的最佳ADC值界值为1.192×10-3 mm2/s,诊断的敏感度和特异度分别为90.3%和92.6%,曲线下面积为0.931。结论 ADC值与乳腺IDC组织学分级存在一定相关性。OBJECTIVE To study the correlation between the diffusion weighted magnetic resonance imaging （DW-MRI） apparent diffusion coefficient （ADC） value and histological grade of breast invasive ductal carcinoma （IDC）. METHODS This retrospective study included 121 patients with IDC verified by histology. Conventional MRI and DW- MRI were performed using a 3.0T MR scanner with b value of 800 s/mm2. ADC of the carcinoma and contralateral normal breast tissues were calculated. ROC analysis was used for distinguishing IDC and contralateral normal breast tissues. RE- SULTS The ADC value of grade I , grade Ⅱ and grade Ⅲ level of IDC were（1. 0434-0. 138） ×10-3^mm2^/s, （0. 871 ± 0. 193） ×10-3^mm2^/s and （0. 654±0. 182） ×10-3^mm2^/s. Significant statistical difference was observed between grade I and Ⅱ , grade Ⅱ and Ⅲ , grade I and Ⅲ. There was negative correlation between histological grade and ADC value. The ADC value of IDC and contralateral normal breast tissues were （0. 864×0. 205） ×10 3 mm2/s and （1. 653±0. 328） × 10.3 mm2/s. Significant statistical difference was observed between IDC and contralateral normal breast tissues. The diagnostic cutoff value for IDC and contralateral normal breast tissues was 1. 192× 10-3 mm2/s. Corresponding sensitivity and specificity were 90.3% and 92.6%, respectively. The area under the ROC curve was 0. 931. CONCLUSION ADC value of breast IDC is correlated with histological grade.

关 键 词：乳腺肿瘤 磁共振成像 病理组织分级 扩散加权成像 

分 类 号：R737.9[医药卫生—肿瘤]