乳腺癌原发灶扩散加权成像预测腋窝淋巴结转移的价值  

The value of diffusion weighted imaging of primary foci of breast cancer to predict metastasis in axillary lymph node

作　　者：鲁果果 李新瑜[1] 王轩轩 许晓亮[1] LU Guoguo;LI Xinyu;WANG Xuanxuan;XU Xiaoliang(Imaging Center,the First Affiliated Hospital of He'nan University of Science and Technology,Luoyang,He'nan Province 471003,China)

机构地区：[1]河南科技大学第一附属医院影像中心,河南洛阳471003

出　　处：《实用放射学杂志》2022年第10期1613-1616,1637,共5页Journal of Practical Radiology

摘　　要：目的探讨乳腺癌原发灶扩散加权成像(DWI)参数最小表观扩散系数(ADCmin)值、平均表观扩散系数(ADCmean)值预测腋窝淋巴结转移的价值。方法回顾性选取经病理证实的乳腺癌患者99例,分为腋窝淋巴结转移组(55例)和腋窝淋巴结未转移组(44例),测量并比较2组的ADCmin值、ADCmean值,以病理结果为金标准,绘制受试者工作特征(ROC)曲线,观察并比较ADCmin值、ADCmean值的预测效能。结果腋窝淋巴结转移组、腋窝淋巴结未转移组ADCmin值分别为(0.638±0.111)×10^(-3) mm^(2)/s、(0.888±0.106)×10^(-3) mm^(2)/s,2组间ADCmean值分别为(0.750±0.119)×10^(-3) mm^(2)/s、(0.964±0.088)×10^(-3) mm^(2)/s,腋窝淋巴结转移组ADCmin值、ADCmean值均小于腋窝淋巴结未转移组,差异均有统计学意义(P<0.05)。绘制ROC曲线,ADCmin值、ADCmean值曲线下面积(AUC)分别为0.948、0.941。根据最大约登指数确定ADCmin、ADCmean的最佳预测阈值,分别为0.746×10^(-3) mm^(2)/s、0.850×10^(-3) mm^(2)/s,ADCmin、ADCmean预测乳腺癌腋窝淋巴结转移的敏感度、特异度分别为95.5%、83.6%和86.4%、78.2%。结论乳腺癌原发灶DWI参数ADCmin值、ADCmean值均可用于预测腋窝淋巴结转移。乳腺癌原发灶ADCmin值越小,腋窝淋巴结发生转移的可能性越大,有易于治疗方案的选择。ObjectiveTo investigate the value of the diffusion weighted imaging(DWI)parameters-the minimum of apparent diffusion coefficient(ADCmin)value and the mean of apparent diffusion coefficient(ADCmean)value of primary foci of breast cancer in predicting metastasis in axillary lymph node.Methods A total of 99 patients of breast cancer confirmed by pathology were retrospectively selected and divided into axillary lymph node metastasis group(55 cases)and axillary lymph node non-metastasis group(44 cases).The ADCmin value and the ADCmean value of the two groups were measured and compared.Receiver operating characteristic(ROC)curve was drawn with pathological results as the gold standard,and the predictive efficacy of the ADCmin value and the ADCmean value were observed and compared.Results The ADCmin values of axillary lymph node metastasis group and axillary lymph node non-metastasis group were(0.638±0.111)×10^(-3) mm^(2)/s and(0.888±0.106)×10^(-3) mm^(2)/s,respectively;The ADCman values of axilary lymph node metastasis group and axillary lymph node non-metastasis group were(0.750±0.119)×10^(-3) mm^(2)/s and(0.964±0.088)×10^(-3) mm^(2)/s,respectively.The ADCmin value and the ADCmean value were lower in axillary lymph node metastasis group than those in axillary lymph node non-metastasis group.Significant inter-group differences were observed in the ADCmin value and the ADCmean value(P<0.05).The area under the curve(AUC)of the ADCmin value and the ADCmean value were 0.948 and 0.941,respectively.With the maximum Youden's index as the cut-off,the ADCmin value and the ADCmean value were 0.746 ×10^(-3) mm^(2)/s and 0.850×10^(-3) mm^(2)/s,respectively.The sensitivity and specificity of ADCmin and ADCmean were 95.5%,86.4%and 83.6%,78.2%for predicting metastasis in axillary lymph node.Conclusion The DWI parameters-ADCmin value and ADCmean value of primary foci of breast cancer are predictive values in the patients with axillary lymph node metastasis.The smaller is ADCmin value of primary foci of breast cancer,the grea

关 键 词：乳腺癌 扩散加权成像 腋窝淋巴结 

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