MR多参数成像对乳腺良恶性病变的价值分析  

The value analysis of MR multiparameter imaging on benign and malignant breast lesions

作　　者：徐敏[1] 马宜传[1] XU Min;MA Yichuan(Department of Radiology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China)

机构地区：[1]蚌埠医学院第一附属医院放射科

出　　处：《包头医学院学报》2019年第7期4-8,共5页Journal of Baotou Medical College

摘　　要：目的:探讨MR多参数联合应用对乳腺良恶性病变的诊断价值及MR表观扩散系数(ADC)值与乳腺浸润性导管癌(IDC)预后因素的相关性。方法:收集临床触诊发现乳腺结节或肿块,经过术后病理证实的女性患者59名。所有患者均行常规MRI、DCE-MRI及DWI扫描。以病理结果为金标准,评价MRI多参数成像及其联合应用对乳腺良恶性病变的诊断效能;经手术病理确诊的32例乳腺浸润性导管癌(IDC),测定病灶的ADC值,记录病灶的预后因子(病理分级、肿瘤大小、淋巴结转移状态)的情况,并与病灶的ADC值进行相关性分析。结果:MR形态学、DCE-TIC、DWI-ADC值及联合应用的诊断敏感性分别为97.1%、94.3%、85.7%、94.3%,特异性分别为70.0%、71.9%、90.6%、90.6%,准确性分别为86.6%、83.6%、88.1%、92.5%;ADC值与病理分级之间差异有统计学意义(F=7.652,P=0.002),且呈负相关(r=-0.535,P=0.002);ADC值与腋窝淋巴结转移状态及肿块大小差异无统计学意义(t=0.198,P=0.844)。结论:MR形态学及TIC单独诊断特异性较低,联合应用特异性提高;ADC值对鉴别乳腺病变的敏感性及特异性均较高,但图像分辨率欠佳,需结合其他参数成像;联合应用的诊断效能最好,诊断价值较高;ADC值可以预测IDC的肿瘤分化程度,对乳腺癌病理分级的判定具有参考价值。Objective:To investigate the diagnostic value of conventional MRI, dynamic enhanced scan(DCE) and diffusion-weighted imaging(DWI) in MR multi parameter imaging for the diagnosis of benign and malignant breast lesions and to explore the correlation between MR apparent diffusion coefficient(ADC) values and prognostic factors in invasive ductal carcinoma(IDC) of breast. Methods:59 female patients with breast nodules and lumps who were confirmed by clinical palpation and pathology were collected. All patients underwent routine MRI, DCE-MRI and DWI scans. The diagnostic efficiency of MRI multi parameter imaging and its combined application in benign and malignant breast lesions were evaluated based on the pathological findings. 32 cases of invasive ductal carcinoma(IDC) confirmed by operation and pathology were selected to determine the ADC values of the lesion, and the prognosis factors(pathological grade, tumor size, lymph node metastasis state) were recorded, and the correlation of the ADC values of the lesion was analyzed. Results:MR morphology, DCE-TIC, DWI-ADC values and combined applications sensitivity were 97.1 %, 94.3 %, 85.7% and 94.3 % respectively;specificity was 70.0 %, 71.9 %, 90.6% and 90.6 % respectively;accuracy was 86.6 %, 83.6 %, 88.1 % and 92.5 % respectively. There was a significant difference between the ADC values and the pathological grade(P=0.002) and negative correlation(P=0.002), and there was no significant difference between the ADC values and the axillary lymph node metastasis state and the size of the mass(P=0.844). Conclusion:The specificity of MR morphology and TIC alone is low, and the combined application is more specific. ADC values have high sensitivity and specificity in differentiating breast lesions, but the image resolution is poor. The diagnostic efficiency of combined application is the best and the diagnostic value is highest. ADC values can predict the degree of differentiation of IDC, and has a reference value for judging the pathological grading of breast cancer.

关 键 词：乳腺病变 动态增强扫描 扩散加权成像 乳腺浸润性导管癌 表观扩散系数 

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]