MRI-DWI和18F-FDGPET/CT对乳腺癌原发灶及腋窝淋巴结转移诊断效能的探讨  

Diagnostic value of MRI-DWI and 18 F-FDG PET/CT in primary breast cancer and axillary lymph nodes metastasis

作　　者：郑超 王西宾[1] 王波[1] 关江涛 文栋[1] 付义斌[1] 熊斌 ZHENG Chao;WANG Xibin;WANG Bo;GUAN Jiangtao;WEN Dong;FU Yibin;XIONG Bin(Department of Medical Imaging Diagnosis,Hanzhong Central Hospital,Hanzhong,Shaani Prorince 723000,China)

机构地区：[1]汉中市中心医院医学影像诊断科,陕西汉中723000

出　　处：《实用放射学杂志》2020年第8期1240-1243,1285,共5页Journal of Practical Radiology

摘　　要：目的比较MRI-DWI和18氟-氟代脱氧葡萄糖(18 F-FDG)PET/CT 2种方法对乳腺癌原发病灶及腋窝淋巴结转移的诊断效能,为临床治疗决策提供依据.方法选取疑为原发性乳腺癌经手术治疗的64例患者.患者术前均行MRI-DWI和18 F-FDG PET/CT检查.结果64例疑似原发乳腺癌患者手术后病理:乳腺癌50例,病灶52个,乳腺非癌病变14例,病灶14个.乳腺癌合并腋窝淋巴结转移24例.MRI-DWI显示乳腺癌原发灶的灵敏度84.6%,特异度100.0%,阳性预测值100.0%,阴性预测值63.6%,准确率87.8%;检测腋窝淋巴结转移的灵敏度50.0%,特异度95.0%,阳性预测值85.7%,阴性预测值76.0%,准确率78.1%.18 F-FDG PET-CT显示乳腺癌原发灶的灵敏度96.0%,特异度85.7%,阳性预测值96.2%,阴性预测值85.7%,准确率94.0%;检测腋窝淋巴结转移的灵敏度91.7%,特异度85.0%,阳性预测值78.6%,阴性预测值94.4%,准确率87.5%.18 F-FDG PET/CT显像检测乳腺癌腋窝淋巴结转移的灵敏度高于MRI-DWI(P=0.015).18 F-FDG PET/CT检测直径≥1 cm病灶的准确度高于检测直径<1 cm病灶(P=0.024).结论MRI-DWI与18 F-FDG PET/CT诊断乳腺癌原发灶效能具有一致性,18 F-FDG PET/CT诊断腋窝淋巴结转移敏感度优于MRI-DWI检查.18 F-FDG PET/CT对病灶直径≥1 cm的乳腺癌原发灶及腋窝转移淋巴结有较高的诊断价值.Objective To compare the diagnostic eficacy of MRI-DWI and 18F-FDG PET/CT in diagnosing primary breast cancer lesions and axillary lymph nodes metastasis,to provide evidence for clinical treatment decisions.Methods 64 patients with suspected of breast cancer and underwent sungery were selected.All the patients underwent MRIHDWI and"F-FDG PET/CT examinations before surgery.Results The postoperative pathology of the 64 patients were 50 breast cancer with 52 lesions,14 noncancerous with 14 lesions.24 breast cancer cases complicated with aillary lymph nodes metastas.As for the MRIH-DWI,the snivitytspesificit,psitire predictive value,ngative predictive value and accuracy in dignosing the primary lesions were 84.6%,100.0%,100.0%,63.6%and 87.8%repectively;the sensitivity,speifcitytpositive predictve value,negative predictive value and acuracy in detction of aillary lymph nodes mcastasis were 50.0%,95.0%.85.7%,76.0%and 78.1%,respectively.As for the 18F-FDG PET-CT,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy in diagnosing the primary lesions were 96.0%,85.7%,96.2%,85.7%and 94.0%,respectivel;the sensitivity,secificit.positive predictive value,negative predictive value and accuracy in detection of aillary lymph nodes metastasis were 91.7%.85.0%,78.6%,94.4%and 87.5%。respectively.The sensitivity of"F-FDG PET/CT in detection of axillary lymph nodes metastasis was higher than that of MRI-DW1(P=0.015).The accuracy of 1"F-FDG PET/CT in detection of lesions≥1 cm in diameter was higher than that in lesions<1 cm(P=0.024).Conclusion MRI-DWI and 18 F-FDG PET/CT have the equal eficacy in diagnosis of primary brcast cancer."F-FDG PET/CT is superior to MRIH-DWI in diagnosis of ailary lymph nodes metastasis."F FDG PET/CT has higher diagnostic value for primary tumors with diameter≥1 cm and axillary lymph nodes metastasis in breast cancers.

关 键 词：乳腺肿瘤 淋巴结转移 磁共振成像 计算机体层成像 正电子发射计算机体层成像 

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