切换至 "中华医学电子期刊资源库"
高级检索
中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2020, Vol. 10 ›› Issue (05) : 201 -205. doi: 10.3877/cma.j.issn.2095-2015.2020.05.003

所属专题： 文献；

临床研究

3.0T磁共振扩散加权成像在乳腺癌诊断及病理分型中的应用价值
梁海昱1, 李洪义1, 高丹2, 汤洋3, 邢健1,†()   
  1. 1. 157011　黑龙江牡丹江，牡丹江医学院附属红旗医院磁共振科
    2. 157011　黑龙江牡丹江，牡丹江医学院附属红旗医院病理科
    3. 157009　黑龙江牡丹江，牡丹江市肿瘤医院磁共振科
  • 收稿日期:2020-06-23 出版日期:2020-10-01
  • 通信作者: 邢健
  • 基金资助:
    黑龙江省教育厅省属高校基本科研立项(2017-KYYWFMY-0683)

Application value of 3.0T magnetic resonance diffusion weighted imaging in the diagnosis and pathological classification of breast cancer

Haiyu Liang1, Hongyi Li1, Dan Gao2, Yang Tang3, Jian Xing1,†()   

  1. 1. Department of Magnetic Resonance, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang 157011, China
    2. Department of Pathology, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang 157011, China
    3. Department of Magnetic Resonance, Mudanjiang Tumor Hospital, Mudanjiang 157009, China
  • Received:2020-06-23 Published:2020-10-01
  • Corresponding author: Jian Xing
  • About author:
    Corresponding author: Xing Jian, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

梁海昱, 李洪义, 高丹, 汤洋, 邢健. 3.0T磁共振扩散加权成像在乳腺癌诊断及病理分型中的应用价值[J]. 中华消化病与影像杂志(电子版), 2020, 10(05): 201-205.

Haiyu Liang, Hongyi Li, Dan Gao, Yang Tang, Jian Xing. Application value of 3.0T magnetic resonance diffusion weighted imaging in the diagnosis and pathological classification of breast cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2020, 10(05): 201-205.

目的

探讨3.0T磁共振扩散加权成像（DWI）在乳腺癌诊断中的应用价值，并分析表观弥散系数（ADC）对乳腺癌病理分型的意义。

方法

回顾性分析2017年9月至2018年9月牡丹江医学院附属红旗医院收治的经手术或穿刺活检病理证实的72例乳腺癌患者。比较MR平扫、DWI及两者联合诊断乳腺癌的准确性；比较b值为1000 s/mm2时不同病理类型乳腺癌ADC值的差异。

结果

本组72例乳腺癌患者，病理证实非浸润性癌19例（导管内原位癌17例，小叶原位癌2例）；浸润性癌53例（浸润性导管癌42例，浸润性小叶癌11例）。MR平扫、DWI及两者联合诊断本组72例乳腺癌患者的准确率分别为88.9%（64/72）、65.3%（47/72）、95.8%（69/72）。b值为1000 s/mm2时，导管内原位癌与浸润性导管癌、小叶原位癌与浸润性小叶癌平均ADC值差异均有统计学意义（t=0.015，P<0.001；t=3.095，P<0.05）。

结论

DWI对乳腺癌的诊断有一定的临床价值，MR平扫与DWI两者联合对乳腺癌诊断具有较高的准确性。ADC值对乳腺浸润性癌与非浸润性癌的区分有价值。

关键词: 磁共振成像, 扩散加权成像, 表观弥散系数, 乳腺癌, 病理分型
Objective

To explore the application value of 3.0T magnetic resonance (MR) diffusion weighted imaging (DWI) in the diagnosis of breast cancer, and to analyze the significance of apparent dispersion coefficient (ADC) in the pathological classification of breast cancer.

Methods

A total of 72 patients with breast cancer pathologically confirmed by surgery or puncture biopsy were analyzed retrospectively in Hongqi Hospital of Mudanjiang Medical College from September 2017 to September 2018. The accuracy of MR plain scan, DWI and the combination of the two for the diagnosis of breast cancer was compared. When the b value was selected as 1000 s/mm2, the difference in ADC value of different pathological types of breast cancer was compared.

Results

In this group of 72 breast cancer patients, 19 cases were pathologically confirmed as non-invasive carcinoma (17 cases of inductal carcinoma in situ, 2 cases of lobular carcinoma in situ), 53 cases of invasive carcinoma (42 cases of invasive ductal carcinoma and 11 cases of invasive lobular carcinoma). The diagnostic accuracy of 72 breast cancer patients with MR plain scan, DWI and the combination of the two was 88.9%(64/72), 65.3%(47/72) and 95.8%(69/72), respectively. When the b value was 1000 s/mm2, the difference of ADC value between invasive breast cancer and non-invasive cancer was statistically significant (P<0.05).

Conclusions

DWI has certain clinical value in the diagnosis of breast cancer. The combination of MR plain scan and DWI has a high accuracy in the diagnosis of breast cancer. ADC values are valuable for the differentiation of invasive and non-invasive breast cancer.

Key words: Magnetic resonance image, Diffusion weighted imaging, Apparent diffusion coefficient, Breast cancer, Pathological classification
图1 患者，女性，41岁，左乳占位。磁共振扫描示：左乳外上象限见类圆形肿块，T1WI像呈低信号影，T2WI像呈中心高信号影，其内见稍低信号影，磁共振DWI扫描呈明显高信号影，b=1000 s/mm2时测得ADC值，术后病理为浸润性导管内癌。图A为横轴位T1WI图；图B为横轴位T2WI图；图C为横轴位DWI图；图D为横轴位b=1000 s/mm2时ADC图；图E为术后病理图（HE，×40）
1
侯桑怡，朱怀仕，樊云飞.动态增强扫描MR及弥散加权MRI在监测乳腺癌保乳术后肿瘤复发中的价值[J].影像研究与医学应用, 2018, 2(16): 71-72.
2
冯莉莉，周红悦，麻增林.动态增强扫描MR及弥散加权MRI在监测乳腺癌保乳术后肿瘤复发中的价值[J].广东医学, 2017, 38(10): 1561-1564.
3
邓子晴，刘超，鲁际. MR影像组学在乳腺癌术前评估中的应用进展[J].影像诊断与介入放射学, 2019, 28(3): 225-229.
4
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality world-wide for 36 cancers in 185 countries [J]. CA Cancer J Clin, 2018, 68(6): 394-424.
5
刘超，鲁际.高场强MR诊断乳腺癌的技术应用进展[J].放射学实践, 2019, 34(5): 583-586.
6
Morrow M, Hawley ST, McLeod MC, et al. Surgeon attitudes and use of MRI in patients newly diagnosed with breast cancer [J]. Ann Surg Oncol, 2017, 24(7): 1889-1896.
7
Park SH, Choi HY, Hahn SY. Correlation between apparent diffusion coefficient values of invasive ductal carcinoma and pathologic factors on diffusion-weighted MRI at 3.0 Tesla [J]. J Magn Reson Imaging, 2015, 41(1): 175-182.
8
史天亮，吴敏. MR动态增强曲线联合DWI诊断乳腺癌的价值分析[J].临床合理用药, 2018, 11(4A): 144-145.
9
Takei J, Tsunoda H, Yagata H, et al. Sustained interruption of anterior interfaces between adipose tissues and mammary glands in ultrasonography after complete pathological remission after neoadjuvant chemotherapy for primary breast cancer [J]. Clin Breast Cancer, 2016, 16(3): 196-201.
10
Klauschen F, Wienert S, Schmitt WD, et al. Standardized Ki67 diagnostics using automated scoring--clinical validation in the GeparTrio Breast Cancer Study [J]. Clin Cancer Res, 2015, 21(16): 3651-3657.
11
Hu B, Xu K, Zhang Z, et al. A radiomic nomogram based on an apparent diffusion coefficient map for differential diagnosis of suspicious breast findings [J]. Chin J Cancer Res, 2018, 30(4): 432-438.
12
Bickelhaupt S, Paech D, Kickingereder P, et al. Prediction of malignancy by a radiomic signature from contrast agent-free diffusion MRI in suspicious breast lesions found on screening mammography [J]. J Magn Reson Imaging, 2017, 46(2): 604-616.
13
Osako T, Nishimura R, Okumura Y, et al. Predictive significance of the proportion of ER-positive or PgR-positive tumor cells in neoadjuvant chemotherapy for operable HER2-negative breast cancer [J]. Exp Ther Med, 2010, 70(24): 66-71.
14
Nelson DA, Tan TT, Rabson AB, et al. Hypoxia and defective apoptosis drive genomic instability and tumorigenesis [J]. Genes Dev, 2004, 18(17): 2095-2107.
15
薛珂，丁莹莹，孙诗昀,等.利用MR动态增强纹理分析评估不同分子亚型乳腺癌异质性[J].医学影像学杂志, 2020, 30(2): 221-226.
16
Laura M, Veronica D, Ilaria B, et al. Correlations between diffusion-weighted imaging and breast cancer biomarkers [J]. Eur Soc Radiol, 2012, 22(6): 1519-1528.
[1] 丁建民, 秦正义, 张翔, 周燕, 周洪雨, 王彦冬, 经翔. 超声造影与普美显磁共振成像对具有高危因素的≤3 cm肝结节进行LI-RADS分类诊断的前瞻性研究[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 930-938.
[2] 张莲莲, 惠品晶, 丁亚芳. 颈部血管超声在粥样硬化斑块易损性评估中的应用价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 816-821.
[3] 邵华, 那子悦, 荆慧, 李博, 王秋程, 程文. 术前经皮超声造影对乳腺癌腋窝前哨淋巴结转移及负荷的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 849-853.
[4] 张旭, 徐建平, 苏冬明, 王彩芬, 王大力, 张文智. 男性乳腺肿块的超声造影特征[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 854-859.
[5] 康一坤, 袁芃. 三阴性乳腺癌分子遗传学及临床特征研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 290-293.
[6] 马伟强, 马斌林, 吴中语, 张莹. microRNA在三阴性乳腺癌进展中发挥的作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 111-114.
[7] 冯冰, 邹秋果, 梁振波, 卢艳明, 曾奕, 吴淑苗. 老年非特殊型浸润性乳腺癌超声征象与分子生物学指标的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 48-51.
[8] 栗艳松, 冯会敏, 刘明超, 刘泽鹏, 姜秋霞. STIP1在三阴性乳腺癌组织中的表达及临床意义研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 52-56.
[9] 韩宇, 张武, 李安琪, 陈文颖, 谢斯栋. MRI肝脏影像报告和数据系统对非肝硬化乙肝患者肝细胞癌的诊断价值[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 669-673.
[10] 雷漫诗, 邓锶锶, 汪昕蓉, 黄锦彬, 向青, 熊安妮, 孟占鳌. 人工智能辅助压缩感知技术在上腹部T2WI压脂序列中的应用[J]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 551-556.
[11] 钟广俊, 刘春华, 朱万森, 徐晓雷, 王兆军. MRI联合不同扫描序列在胃癌术前分期诊断及化疗效果和预后的评估[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 378-382.
[12] 吴钰娴, 冯亚园, 霍雷, 贾宁阳, 张娟. 原发性肝脏淋巴瘤的影像学诊断价值研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 349-353.
[13] 赵文毅, 邹冰子, 蔡冠晖, 刘永志, 温红. 超声应变力弹性成像联合MRI-DWI靶向引导穿刺在前列腺病变诊断中的应用[J]. 中华临床医师杂志(电子版), 2023, 17(9): 988-994.
[14] 刘飞, 王影新, 马骍, 辛灵, 程元甲, 刘倩, 王悦, 张军军. 不同介质腔内心电图定位技术在乳腺癌上臂输液港植入术中应用的随机对照研究[J]. 中华临床医师杂志(电子版), 2023, 17(07): 760-764.
[15] 岳瑞雪, 孔令欣, 郝鑫, 杨进强, 韩猛, 崔国忠, 王建军, 张志生, 孔凡庭, 张维, 何文博, 李现桥, 周新平, 徐东宏, 胡崇珠. 乳腺癌HER2蛋白表达水平预测新辅助治疗疗效的真实世界研究[J]. 中华临床医师杂志(电子版), 2023, 17(07): 765-770.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号