利用3.0T MR血管成像探讨乳腺癌周围血供特点及相关因素  

Application of 3.0T MR vascular imaging in studying characteristics and related factors of blood supply around breast cancer

作　　者：徐海燕[1] 赵红[1] 邹立巍[1] 郑穗生[1] 钱波[1] 

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230022

出　　处：《中华全科医学》2016年第1期108-110,130,共4页Chinese Journal of General Practice

基　　金：安徽省自然科学基金项目(1308085QH152);安徽省质量工程项目-医学影像学教学团队(2014jxtd119)

摘　　要：目的利用3.0T MR血管成像探讨乳腺癌周围血供特点及与肿瘤形态、大小、表观扩散系数(apparent diffusion coefficient,ADC)值及病理分级的相关性。方法 94例行3.0T MR动态增强扫描检查并经组织病理学证实的乳腺癌患者。分析形态学资料并测量病灶最大径、肿瘤实性部分的ADC值,并从临床获取病理分级资料,利用ADW 4.4工作站,对动态增强图像中强化最明显图像与平扫图像进行减影,用最大密度投影法(maximum intensity projection,MIP)获取双乳3D减影图,在3D-MIP图像上记录乳腺癌病灶周围血管及对侧乳腺相对应区域的血管数、血管内径、血管长度,分析患侧乳腺血供特点及与肿瘤形态、大小、肿瘤实性部分ADC值及病理分级的相关性。结果 94例乳腺癌患者中,79例乳腺癌病灶周围血供较对侧异常增多,肿瘤血管主要表现为血管走形迂曲或僵直,供血血管管径增粗,远端分支小血管增多,并围绕肿瘤分布。乳腺癌患侧周围异常增多的血管数与病灶形态差异无统计学意义(χ2=0.071,P>0.05);乳腺癌病灶周围异常增多的血管数与病灶大小、病灶实性部分的ADC值差异有统计学意义(r1=0.567,r2=0.230,P<0.05),与浸润性导管癌的病理分级差异无统计学意义。结论乳腺癌为富血供肿瘤。乳腺癌病灶周围异常增多的血管数与病灶大小、ADC值呈正相关;与病灶形态、浸润性导管癌的病理分级无明显相关性。Objective To study the characteristics of blood supply around the breast cancer and correlation with tumor size,shape, apparent diffusion coefficient （ADC） values and pathological grading. Methods Ninty-four cases of breast cancer confirmed by histopathology and examined by 3.0T MR dynamic enhanced scan were enrolled into this study. Sie- mens 3.0T magnetic resonance instrument was used for the morphological data as well as the maximum diameter of le- sions, ADC values, and pathological classification data were obtained from the clinical material. ADW4.4 workstation was adopted to subtract the scan image from the most striking enhanced image in dynamic enhanced image, and maximum in- tensity projection（MIP） was used to acquire the bilateral breast 3 D subtraction angiography images. Besides, the number, diameter, and length of surrounding blood vessels and the contralateral breast vessels were recorded, and the correlation between characteristics of blood supply of the affected mammary gland and its tumor shape, size, ADC values and patholog- ical classification were analyzed. Results Among the 94 cases, the blood supply around the lesions in 79 cases increased more than the contralateral side. The main performances of breast artery anomalies and tumor blood vessels in this study lied in that the tumor blood vessels were more concentrated on the edge of the tumor area; the diameter of blood vessel en- larged, the number of terminal small arteries increased and their go-line was irregular and twisted. The number of abnormal arterial around the breast lesions and tumor blood vessels shown in enhanced MR and MIP reconstruction were correlated with the size and the ADC values of the lesions. The maximum diameter and the ADC values of the tumor were positively correlated with the number of peripheral vascular lesions （ r1 = 0. 567, r2 = 0. 230, P 〈 0.05 ）. The tumor shape and the pathological grading of infiltrating ductal carcinoma were not significantly correlated with the number of surrounding blood v

关 键 词：乳腺癌 磁共振成像 最大密度投影 ADC值 病理分级 

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