扩散加权成像对不同病理类型乳腺癌的鉴别诊断价值

Difffusion weighted imaging in differentiating the histopathological type of breast carcinoma

目的:探讨扩散加权成像(DWI)及ADC值(ADC)测量对不同病理类型乳腺癌的鉴别诊断价值。方法:回顾分析50例经病理证实的乳腺癌患者的MRI资料,DWI检查采用EPI技术,分别测量乳腺病灶及正常乳腺ADC值,对不同病理类型乳腺癌的ADC值进行单因素方差分析并进行两两比较。结果:50例中浸润性导管癌34例,黏液腺癌6例,乳头状癌4例,浸润性筛状癌4例和髓样癌2例。乳腺癌和正常组织的ADC值分别为(1.31±0.06)×10-3及(2.06±0.04)×10-3mm2/s。浸润性导管癌、黏液腺癌、乳头状癌及筛状癌之间ADC值差异有统计学意义(F=9.406,P<0.05),黏液腺癌与浸润性导管癌、乳头状癌及筛状癌之间ADC值差异有统计学意义(P<0.01),浸润性导管癌与乳头状癌及筛状癌间的ADC值差异无统计学意义(P值分别为0.671和0.333)。结论:不同类型乳腺癌因病理基础不同,ADC值变化存在一定差异,ADC值测量有助于部分病理类型乳腺癌的鉴别诊断。

Objective：The purpose of this study was to demonstrate the features of different breast carcinomas by DWI.Methods：MRI data of fifty patients with surgicopathological diagnosis of breast carcinoma were analyzed.DWI was performed with single shot echo plannar imaging technique.The apparent diffusion coefficient（ADC） values of both the lesion and the normal breast tissue were recorded.The ADC values of different breast carcinomas were assessed by one-way analysis of variance（ANOVA）.Results：In the 50 cases there were 34 ductal carcinomas,6 mucinous carcinomas,4 papillary carcinomas,4 cribriform carcinomas and 2 medullary carcinomas.The mean ADC value of the lesions and the normal tissue was（1.31±0.06）×10-3mm2/s and（2.06±0.04）×10-3mm2/s respectively.A significant difference was found between the lesions and the normal breast tissue（t value=-7.997,P0.05）.A significant difference was found between the different type carcinomas（F=9.406,P0.05）.A significant difference was found between the mucinous carcinomas and the others（P0.05）,while there was no significant difference among the ductal carcinomas,papillary carcinomas and the cribriform carcinomas.Conclusion：The ADC values of different breast carcinomas may exhibit variations owing to their different pathological basis.The ADC value measuring is helpful for differential diagnosis of breast carcinoma of the different pathological type.