磁共振DWI序列在早期乳腺癌诊断中的价值  

Value of magnetic resonance DWI sequence in diagnosis of early breast cancer

作　　者：程雪[1] 徐民[1] 夏海红 肖扬锐 刘建平[1] 刘纯方 程淑芳[1] CHENG Xue;XU Min;XIA Haihong;XIAO Yangrui;LIU Jianping;LIU Chunfang;CHENG Shufang(Department of Radiology, Lishui Central Hospital, Zhejiang Province, Lishui 323000, P.R.China)

机构地区：[1]浙江省丽水市中心医院放射科,浙江丽水323000

出　　处：《医学影像学杂志》2020年第12期2236-2239,2243,共5页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2016KYA201)。

摘　　要：目的探讨磁共振扩散加权成像(DWI)序列在早期乳腺癌诊断中的价值。方法选取2018年6月~2019年6月于我院确诊乳腺癌患者共116例,其中早期组(导管内癌和小叶癌I期)50例,中晚期组(II^IV期)66例,另选择60例乳腺良性结节作为对照组。采用磁共振常规序列(T2WI)、增强成像(时间-信号强度曲线)和DWI序列(ADC和rADC值),比较各组患者上述指标的差异性。结果针对T2WI序列不同强度的信号百分比发现,乳腺癌早期组、中晚期组以及对照组患者等或低信号以及高信号百分比无明显差异(P>0.05)。针对动态增强序列中时间-信号强度曲线分成3型,其中乳腺癌早期组、中晚期组未出现I型曲线,以III型为主,而对照组以I^II型为主(P<0.05),但乳腺癌早期组、中晚期组间比较无明显差异(P>0.05)。针对DWI序列发现,乳腺癌中晚期肿瘤病灶ADC和rADC值明显小于早期组,对照组最高(P<0.05)。以rADC值为诊断指标纳入受试者工作曲线(ROC)发现,rADC值诊断乳腺癌的准确性(曲线下面积AUC值)为0.834,临界值0.75,诊断早期乳腺癌的准确性为0.821,临界值0.64。结论磁共振DWI序列诊断乳腺癌时ADC和rADC值明显降低,中晚期比早期进一步下降,可作为乳腺癌诊断和临床分期的重要指标,有较高的准确性。Objective To analyze value of diffusion weighted imaging(DWI)sequence with magnetic resonance in diagnosis of early breast cancer.Methods A total of 116 patients as breast cancer from June 2018 to June 2019 were enrolled,with 50 of early stage(ductal carcinoma in situ and lobular carcinoma I class),other 66 of advanced stage(II^IV class),60 of benign breast nodules as control.Then,we compared differences of conventional magnetic resonance sequence(T2WI),enhanced imaging(time-signal intensity curve)and DWI sequence(ADC and rADC values).Results According to the signal percentages of different intensity in T2WI sequence,there were no differences of percentages of equal or low signal,and high signal in early,advanced breast cancer group and control group(P>0.05).The time-signal intensity curve of dynamic enhancement sequence was divided into three types,there was no type I curve in breast cancer group,and type III curve was dominant,type I^II curve was more in control group(P<0.05),but there was no difference between early and advanced breast cancer group(P>0.05).According to DWI sequence,the ADC and rADC values in advanced breast cancer group were significantly lower than early group,control group was the highest(P<0.05).The accuracy of rADC in diagnosing breast cancer(AUC value of area under curve)was 0.834,cut-off value was 0.75,the accuracy in diagnosing early breast cancer was 0.821 and 0.64 respectively,by rADC value as diagnostic indicator in receiver operating curve(ROC).Conclusion The values of ADC and rADC in diagnosis of breast cancer by MR DWI sequence is lower,much less in advanced stage than early stage,which can be an important indicator for diagnosis and clinical staging of breast cancer with high accuracy.

关 键 词：磁共振成像 乳腺癌 

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]