多参数MR在乳腺非特殊类型浸润性癌中的应用
摘要
目的研究多种参数MR在乳腺非特殊类型浸润性癌的诊断特点。方法对比了31例非特殊类型浸润性癌、10例其他类型乳腺癌及26例良性乳腺病变的患病年龄,病变大小,分布;MR形态学(形状、边缘,强化方式),时间信号强度曲线的分型,达峰时间,ADC值及r ADC方面的诊断特点及统计学差异。结果非特殊类型浸润性癌患病年龄均值47.23岁;左乳18例,右乳13例;大小均值19.94mm;圆形或卵圆形3例、分叶状及不规则形28例,边缘光滑2例、不规则或毛刺29例,均匀强化2例、不均匀及环形强化29例,TIC曲线Ⅰ型1例、Ⅱ型23例、Ⅲ型7例,达峰时间3分钟内27例、>3分钟的4例,ADC值0.843±0.197×10~(-3)mm~2/s,r ADC值0.52±0.17。其他类型乳腺癌患病年龄均值46.50岁;左乳3例,右乳7例;大小均值24.00mm;圆形或卵圆形1例、分叶状及不规则形9例,边缘光滑1例、不规则或毛刺9例,均匀强化0例、不均匀或环形强化10例,TIC曲线Ⅰ型3例、Ⅱ型5例、Ⅲ型2例,达峰时间3分钟内7例、>3分钟3例,ADC值1.057±0.452×10-3mm~2/s,r ADC值:0.62±0.29。良性乳腺病变患病年龄均值40.85岁;左乳17例,右乳9例;大小均值16.00mm;圆形或卵圆形5例、分叶状或不规则形21例,边缘光滑16例、不规则或毛刺10例,均匀强化16例、不均匀或环形强化10例,TIC曲线Ⅰ型8例、Ⅱ型18例、Ⅲ型0例,达峰时间3分钟以内9例、>3分钟17例,ADC值1.490±0.312×10-3mm2/s,r ADC值0.89±0.26。结论患病年龄、形态学、TIC曲线分型、达峰时间、ADC、r ADC在良、恶性鉴别中均有差异,乳腺非特殊类型浸润性癌的ADC值低于其他类型乳腺癌和乳腺良性病变的ADC值。
引文
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[3]Liberman L,Morris EA,Lee MJ,et al.Breast lesions detected on MR imaging:features and positive predictive value[J].AJR,2002,179:171-178.
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[5]刘书政,黄韬.磁共振成像动态增强对乳腺癌血管生成的研究[J].中国肿瘤临床,2005,32(9):516-519.
[6]刘明霞,唐志全,张艺军,等.3T磁共振高分辨率动态增强诊断小乳癌的应用研究[J].医学影像学杂志,2011,21(9):1349-1351.
[7]Barrett T,Brechbiel M.MRI of tumor angiogenesis[J].Journal of Magnetic Resonance Imaging,2007,26(2):235-249.
[8]夏琬君,程敬亮,路彦涛,等.MRI动态增强7项参数对乳腺良恶性病灶的诊断价值[J].实用放射学杂志,2014,30(12):1986-1988.
[9]李俊,赵卫.3.0T磁共振动态增强及扩散加权成像对乳腺病变的诊断价值[J].实用放射学杂志,2013,29(12):1940-1944.
[10]Ei Khouli RH,Jacobs MA,Mezban SD,et al.Diffusion-weighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging[J].Radiology,2010,256(1):64-73.
[11]钟美花,易本清,吕敦召,等.3.0T磁共振在乳腺疾病检查中的应用分析[J].江西医药,2014,49(2):121-123.
[12]Padhani AR,Koh DM,Collins DJ.Whole-body diffusion-weighted MR imaging in cancer:current status and research direction[J].Radiology,2011,261(3):700-718.
[13]Yabuuchi H,Matsuo Y,Kamitani T,et al.Non-mass-like enhancement on contrast-enhanced breast MR imaging:Lesion characterization using combination of dynamic contrast-enhanced and diffusion-weighted MR images[J].Eur J Radiol,2010,75(1):e126-e132.
[14]朱萍,王亚非,黄昊,等.MR扩散加权成像表现扩散系数在乳腺结节病变诊断中的应用价值[J].中华放射学杂志,2011,45(12):1117-1121.
[15]鲁文力,欧阳祖彬,李信友,等.ADC和r ADC值对乳腺良恶性病变的诊断效能[J].吉林大学学报(医学版),2016,42(1):159-163.
[16]Nogueira L,Brandao S,Matos E,et al.Improving malignancy prediction in breast lesions with the combination of apparent diffusion coefficient and dynamic contrast-enhanced kinetic descriptors[J].Clin Radiol,2015,70(9):1016-1025.