摘要
目的:探讨动态增强及弥散加权成像在不同病理类型中的乳腺癌鉴别诊断价值。方法:回顾分析49例经病理证实(34例浸润性导管癌,7例黏液腺癌,4例乳头状癌,4例浸润性筛状癌)的乳腺癌MRI资料,病例均行MRI动态增强检查及DWI成像,绘制时间-信号强度曲线,计算早期强化率及峰值强化率,测量病灶ADC值,并进行单因素方差分析及正常对照组ADC值配对配对t检验。结果:动态增强MRI显示时间-信号强度曲线Ⅲ型34例(69.3%),Ⅱ型10例(20.4%),Ⅰ型5例(10.2%)。浸润性导管癌、黏液腺癌、筛状癌及乳头状癌之间的早期强化率有明显差异(F=3.399,P=0.027<0.05),峰值强化率无明显差异(F=2.241,P=0.099>0.05),ADC值有显著性差异(F值为37.954,P=0.000<0.05)。黏液腺癌与浸润性导管癌的早期强化率及ADC值均有明显差异(P=0.042,0.000<0.05)。结论:乳腺癌因其病理基础不同,表现出不同的MRI特征,动态增强MRI及ADC值测量对部分病理类型的鉴别可提供一些参考,其中对黏液腺癌与浸润性导管癌的鉴别诊断具有重要参考价值。
Purpose： The purpose was to demonstrate the features of different breast carcinomas by DCE - MRI and DWI. Methods： By using a retrospective database, forty - nine patients with surgicopathological diagnosis of breast carcinoma were conducted. All patients underwent dynamic enhanced scan and DWI. Time intensity curves（TICs） were obtained from the regions showing maximal enhancement in the enhanced images and classified as monophasic（type Ⅰ ）, biphasic（type Ⅱ ）, or washout（type Ⅲ ） . The enhancement rate and the apparent diffusion coefficient（ADC） values were recorded and analyzed by oneway analysis of variance（ANOVA） . Results： There were thirtyfour infiltrative ductal carcinomas, seven mucinous carcinomas, four papillary carcinomas, four cribriform carcinomas. Of the forty- nine patients,TICs were shown as type Ⅲ in 34（69.3%）, type Ⅱ in 10（20.4%）, and type Ⅰ in 5 （10.2 % ）. Significant statistical differences were found in the early enhancement rates and the ADC values between the groups. There was no significant difference in the maximal enhancement rates among the four types carcinomas. Conclusion： DCE - MR imaging with DWI can offer additional morphological informations about different types of breast carcinomas and improve our ability to differentiate the histopathological types of breast carcinoma cases. It is helpful for us to differentiate infiltrative ductal carcinomas and mucinous carcinomas by ADC values and TICs.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2011年第4期317-322,共6页
Chinese Computed Medical Imaging
关键词
乳腺肿瘤
磁共振成像
动态增强
弥散加权成像
Breast carcinoma
MR imaging
Dynamic enhancement
Diffusion weighted imaging
