腋窝良恶性淋巴结的MR弥散加权成像研究

Evaluation of axillary lymph node metastases using diffusion-weighted imaging

目的评价MR弥散加权成像(diffusion-weighted imaging,DWI)对乳腺癌淋巴结转移的诊断价值。方法收集24例乳腺癌伴腋窝淋巴结肿大患者,行常规MR及MR弥散加权成像序列扫描,测量淋巴结的表观弥散系数(apparent diffusion coefficient,ADC),结合术后病理结果进行对照分析。结果转移性淋巴结与良性增生淋巴结的ADC值分别为(0.796±0.171)×10-3mm2/s和(1.058±0.234)×10-3mm2/s,差异有统计学意义(P<0.05);以0.854×10-3mm2/s作为ADC值诊断淋巴结转移的阈值,其灵敏度、特异度和准确度分别为73.91%、86.96%和80.43%。结论弥散加权成像对乳腺癌淋巴结转移灶的诊断具有重要价值。

Objective To evaluate the ability of diffusion-weighted imaging（DWI） to diagnose axillary lymph node metastases in patients with breast cancer. Methods Preoperative conventional MR and DWI imaging was performed on 24 patients with breast cancer and enlarged axillary lymph nodes.The apparent diffusion coefficient （ADC） of axillary lymph nodes was determined,and its rela- tionship to histopathologic findings was analyzed. Results The ADC value of metastatic lymph nodes （0.796±0.171） ×10^-3 mm2/s was significantly lower than that of benign nodes（ 1.058±0.234,P〈0.05 ）×10^-3 mm2/s.With the threshold ADC value at 0.854×10^-3 mm2/s for diagnosing lymph node metastasis, the sensitivity, specificity and accuracy were, respectively, 73.91%, 86.96% and 80.43%. Conclusion DWI is useful for detecting axillary lymph node metastases in patients with breast cancer.