乳腺癌肝转移瘤钆塞酸二钠增强MRI肝胆期特征及其诊断价值  

Features of breast cancer liver metastases on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced MRI and its diagnostic value

作　　者：陈小草 郑冰洁 黎海亮 CHEN Xiaocao;ZHENG Bingjie;LI Hailiang(Department of Radiology,the Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院放射科,河南郑州450008

出　　处：《实用放射学杂志》2023年第6期932-936,共5页Journal of Practical Radiology

摘　　要：目的探讨乳腺癌肝转移瘤(BCLM)钆塞酸二钠(Gd-EOB-DTPA)增强MRI影像特征及肝胆期表现在鉴别不同分子分型BCLM中的价值。方法选取经病理证实的BCLM患者61例(222个转移灶),分析病灶在Gd-EOB-DTPA增强MRI各序列中的信号强度(SI)、强化方式,测量其表观扩散系数(ADC),计算病灶与肝实质信号强度比(SIR),比较不同分子分型BCLM间ADC值、SIR及肝胆期影像特征的差异。结果转移灶在动脉期以环形强化为主,门脉期以不均匀强化为主,延迟期以靶征为主,肝胆期83.33%病灶呈靶征或反靶征。Luminal A型BCLM的SIR高于Luminal B型、三阴性型(P<0.05),Luminal A型肝胆期靶征占比最高(P<0.05),且肝胆期特征与分子分型之间有相关性(r=0.266,P<0.05)。结论BCLM Gd-EOB-DTPA增强MRI肝胆期特征以靶征或反靶征为主,肝胆期表现在4种分子亚型BCLM间不同,具有鉴别诊断分子分型的潜力。Objective To explore the imaging characteristics of breast cancer liver metastases(BCLM)in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI and the value of hepatobiliary phase manifestations in identifying different molecular subtypes of BCLM.Methods A total of 222 metastases from 61 patients with BCLM confirmed by pathology were selected.The signal intensity(SI)and enhancement patterns of the lesions in each phase of Gd-EOB-DTPA enhanced MRI were analyzed.The apparent diffusion coefficient(ADC)was measured and the signal intensity ratio(SIR)of the lesions to liver parenchyma was calculated.The differences of ADC value,SIR and imaging characteristics of hepatobiliary phase among different molecular subtypes of BCLM were compared.Results Hepatic metastases mainly showed peripheral enhancement in the arterial phase,heterogeneous enhancement in the portal phase,and target appearance in the delayed phase.In the hepatobiliary phase,83.33% of the lesions were found with the target appearance or reversed target appearance.The SIR of BCLM Luminal A type was higher than that of Luminal B type and triple-negative type(P<0.05),while Luminal A type had the highest proportion of hepatobiliary target appearance(P<0.05).The hepatobiliary phase features were correlated with molecular subtypes(r=0.266,P<0.05).Conclusion In Gd-EOB-DTPA enhanced MRI,the hepatobiliary phase features of BCLM are mainly target appearance or reversed target appearance,and the manifestations are different among the four molecular subtypes of BCLM,which has the potential value for differential diagnosis of molecular subtypes.

关 键 词：乳腺癌肝转移瘤 钆塞酸二钠 肝胆期 磁共振成像 

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