动态增强MRI及ADC值对乳腺微浸润癌的诊断价值  被引量:6

The Diagnostic Value of Dynamic Contrast-Enhanced MRI and ADC Value in Breast Carcinoma with Microinvasion

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作  者:童明敏[1] 蔡红法[1] 蔡庆[1] 沈宣文[1] 陈倩[1] 沈玉英[1] 

机构地区:[1]南京医科大学附属苏州医院,苏州市立医院东区放射科,215001

出  处:《临床放射学杂志》2016年第6期866-870,共5页Journal of Clinical Radiology

基  金:苏州市科技计划项目(编号:SYS201357);苏州市肿瘤临床医学中心项目(编号:SZZX201506)

摘  要:目的探讨动态增强MRI联合ADC值对乳腺微浸润癌(DCIS-MI)的诊断价值。方法搜集经病理证实的100例乳腺病患者MRI资料,其中DCIS-MI 40例,浸润性导管癌(IDC)44例及良性病变16例,全部行动态增强扫描及DWI(b=50、600、1000 s/mm^2),以DCIS-MI为研究主题,对比分析病灶形态学特征、时间-信号强度曲线(TIC);定量分析三类病变ADC值(b=1000 s/mm^2)差异及ADC诊断阈值。结果病变强化形态:DCIS-MI以导管样和段样强化为主(25/40,62.5%)、IDC以肿块样强化为主(36/44,81.8%,直径>2 cm)、良性病变以局灶性强化为多(9/16,56%),三者差异有统计学意义(χ~2=47.348,P=0.000)。TIC:DCIS-MI常为Ⅱ型(30/40,75%),IDC曲线多为Ⅲ型(36/44,81.8%),两者有显著性差异(χ~2=24.317、37.991,P=0.000)。ADC值:良性组、DCIS-MI及IDC分别为(1.489±0.244)×10^(-3)mm^2/s、(1.121±0.405)×10^(-3)mm^2/s及(0.851±0.103)×10^(-3)mm^2/s,三者差异有统计学意义(F=25.492,P=0.000)。其ADC诊断阈值分别为1.678×10^(-3)mm^2/s、1.391×10^(-3)mm^2/s、0.939×10^(-3)mm^2/s。DCE-MR联合ADC值对微浸润癌诊断的敏感性、特异性及准确性分别为87.5%、93.8%、89.3%。结论动态增强MRI联合ADC对DCIS-MI的诊断有较高价值。Objective To investigate the value of dynamic contrast-enhanced MRI combined with ADC in the diagnosis of breast ductal carcinoma in situ with microinvasion(DCIS-MI).Methods 100 cases of breast disease with histologically pproven from 2012 to 2015 were retrospectively reviewed on DCE-MRI and DWI(b=50、600、1000 s/mm^2),including 40 cases of DCIS-MI,44 cases of Invasive ductal carcinoma(IDC) and 16 cases of benign lesions.Taking DCIS-MI as research focus,lesion morphology,time-signal intensity curve(TIC) were comparatively analyzed,ADC(Apparent diffusion coefficient,ADC) value(b = 1000 s/mm^2) and ADC threshold of diagnosis were quantitatively analyzed.Results Lesion characteristics : DCIS-MI often showed the ductal and segmental enhancement(25 /40,62.5%),IDC was more of mass-like enhancement(36/44,81.8%,diameter 2 cm),benign lesions were more of focal enhancement(9 /16,56%).There was significant difference among the three groups(χ~2= 47.348,P = 0.000).TIC: DCIS-MI was often Ⅱtype,and IDC was Ⅲ type,both had significant differences(χ~2= 24.317,37.991,P = 0.000).ADC values: benign lesions,DCISMI and IDC,respectively were(1.489 ± 0.244)×10^(-3)mm^2/s,(1.121 ± 0.405) × 10^(-3)mm^2/ s and(0.851 ± 0.103) ×10^(-3)mm^2/ s.All three showed statistical significance(F=25.492,P = 0.000).ADC diagnosis threshold were 1.678×10^(-3)mm^2/ s,1.391 × 10^(-3)mm^2/ s and 0.939×10^(-3)mm^2/ s respectively.The sensitivity,specificity and accuracy of DCEMR combined with ADC in the diagnosis DCIS-MI were 87.5%,93.8% and 89.3% respectively.Conclusion Dynamic enhanced MRI combined with ADC has a higher diagnostic value of DCIS-MI.

关 键 词:磁共振成像 动态增强 表观扩散系数 微浸润癌 

分 类 号:R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]

 

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