乳腺肿瘤MRI序列联合运用与微血管密度的对照研究

Comparative study of MRI sequences combined with microvessel density in breast tumor

目的:探讨同一次检查中T2WI首次通过灌注成像及T1WI动态增强成像的联合应用在鉴别乳腺良恶性肿瘤方面的价值,并对所有病灶进行免疫组化CD34染色计数微血管密度进行评分,评价其相关性。方法:37例乳腺患者经手术或穿刺病理证实分为良恶性两组,经过MRIT2WI首次通过灌注成像后进一步行T1WI动态增强成像,对灌注及动态增强各参数进行分析,并与手术后病理图像及免疫组化结果对照。结果:乳腺肿块37例,乳腺癌21例,乳腺良性病灶16例,应用T2WI首过灌注成像,良恶性组早期信号强度丢失率之间重叠很少,敏感性为90%,特异性为75%;较T1WI动态增强组(敏感性47.6%,特异性为68.7%)提高;恶性组最大信号强度下降率与微血管密度MVD有明显正相关性(r=0.502,P<0.05),最大信号强度下降时间与微血管密度无明显相关性。良性组最大信号强度下降率、最大信号强度下降时间与微血管密度均无明显相关性。结论:乳腺癌T2WI灌注成像表现与病理特征相符,在乳腺癌血管生成的评价方面有重要价值。联合T2WI首次通过灌注成像及T1WI动态增强成像能够提高乳腺肿瘤的诊断特异性。

Objective：To explore the identification value of combined T2WI first-pass perfusion imaging and T1WI dynamic contrast-enhanced imaging in breast cancer in same inspection,then a group of immune CD34 staining count MVD to score,and to evaluate its relation.Methods：37 cases of breast surgey or puncture pathological divided into two groups of benign and malignant.After MRI T2WI first-pass perfusion imaging to further T1WI dynamic contrast-enhanced imaging.The perfusion and dynamic parameters were analyzed and compared with the pathological diagnosis after surgery. Results：37 cases of breast tumors, 21 cases of breast cancer, benign breast lesions in 16 cases,there is little overlap of early maximal signal reduction ratio between benign and malignant group, the sensitivity of 90%, the specificity of 75%. It was higher than T1WI dynamic contrast-enhanced group （sensitivity 47.6% and specificity 68.7%）. There was a positive correlation between maximal signal reduction ratio and MVD in malignant group （ r = 0. 502, P 〈 0.05）. There was no correlation between maximal signal reduction time and MVD. There is no correlation between maximal signal reduction ratio, maximal signal reduction time and MVD in benign group. Conclusion： Breast cancer T2WI perfusion performance consisted with the pathological feature, it has important value in the evaluation of breast cancer angiogenesis. The combined criteria of T2WI first-pass perfasion and T1WI dynamic contrast can improve the specifity in the diagnosis of breast tumor.