乳腺浸润性导管癌的3.0TMRI诊断

Diagnosis in 3.0 T MRI of infiltrating ductal carcinoma of breast

目的探讨乳腺浸润性导管癌的3.0T MR影像学特点,提高对浸润性导管癌术前诊断的准确性。材料与方法回顾性分析65例(69病灶)经手术或穿刺病理证实的浸润性导管癌患者的MRI资料,均采用3.0T MRI行平扫、动态增强及DWI序列扫描,分析病灶的MRI影像学特征,包括形态学表现、血流动力学特征、时间-信号曲线(TIC)及ADC值。采用配对设计t检验比较浸润性导管癌病灶和正常乳腺组织ADC值的差异,同时采用成组设计方差分析比较3型曲线间ADC值有无差异。结果 65例(69例病灶)浸润性导管癌表现为肿块型[58.0%(40/69)]或非肿块型[42.0%(29/69)],边缘不规则,T1WI呈等[36.2%(25/69)]或低信号[63.8%(44/69)],T2WI呈稍高[27.5%(19/69)]或高信号[72.5%(50/69)],DWI呈稍高[49.3%(34/69)]或高信号[50.7%(35/69)],增强扫描肿块型呈早期不均匀强化,内部间隔强化,非肿块型以导管样及簇集状强化为主,TIC以Ⅱ型[56.5%(39/69)]、Ⅲ型[37.7%(26/69)]曲线为主,ADC平均值(0.93±0.21)×10-3mm2/s,尚不能认为3型曲线间ADC值差异有统计学意义(F=0.182,P=0.834>0.05)。结论应用3.0T MRI动态增强扫描及DWI序列,能较好的显示病变形态及强化方式,结合形态学表现、血流动力学及功能学特征,有助于对浸润性导管癌的术前诊断。

Objective：To investigate the imaging appearance of infiltrating ductal carcinoma at 3.0 T MRI and improve the diagnosis accuracy of infiltrating ductal carcinoma.Materials and Methods：Imaging data of 65 patients（69 lesions） with infiltrating ductal carcinoma proved by operation or biopsy were retrospectively analyzed.All underwent plain,dynamic contrast-enhanced and DWI scan using 3.0 T MRI.The MRI features analyzed included morphological characteristics,hemodynamic performance,the time-signal intensity curve（TIC） and mean ADC.The ADC values for infiltrating ductal carcinoma and normal breast tissue were compared using paired t test and using the grouping design analysis of variance comparison between three type curve difference between ADC values.Results：Sixty-five cases（69 cases of focal） infiltrating ductal carcinoma were performanced with the mass [58.0%（40/69）] or non-mass-like [42.0%（29/69）],margin irregular,equal [36.2%（25/69）] or low signal intensity [63.8%（44/69）] on T1WI,slightly high [27.5%（19/69）] or high signal intensity [72.5%（50/69）] on T2WI,the DWI is slightly high [49.3%（34/69）] or high signal [50.7%（35/69）],the enhanced scanning mass type was early heterogeneous enhancement,internal septal enhancement,non-mass-like give priority to catheter-like and clustered like,time-signal intensity curve to Ⅱ curve [56.5%（39/69）],Ⅲ curve [37.7%（26/69）] is given priority to.With b=1000 mm^2/s,the mean ADC values for infiltrating ductal carcinoma [（0.93±0.21）×10^-3 mm2/s],still can＇t think three type curve difference between ADC values with a statistical significance（F=0.182,P=0.8340.05）.Conclusion：Application the 3.0 T MRI dynamic contrast-enhanced and DWI scan,can better show lesions form and the strengthen way,combined with morphology characteristics,hemodynamic performance and function characteristics,help to infiltrating ductal carcinoma of preoperative diagnosis.