基于动态增强磁共振的T1WI定量灌注参数伪彩图在导管源性乳腺癌中的诊断价值

The Diagnostic Value of Quantitative T1WI MR Parametric Perfusion-weighted Imaging Based on DCE-MRI in Duct-borne Breast Cancer

目的:探讨基于动态增强的MR T1WI定量灌注参数伪彩图对导管源性乳腺癌的诊断价值。方法:16例女性手术前行双侧乳腺动态高分辨对比增强MR成像(DCE-MRI),绘制时间-信号强度曲线(TIC),基于乳腺动态增强磁共振的数据资料,通过灌注软件获得五种灌注伪彩图,分别为Wash-in、Wash-out、TTP、MIPt及PEI。选取病变的中央(1个)边缘(2个)及对侧相应部位正常乳腺组织(1个)为感兴趣区域,测得其各种灌注参数值,并研究探讨导管源性乳腺癌的灌注特点。结果:16例女性患者经病理学证实为13例浸润性导管癌、3例导管内癌。16个病灶中13例呈非肿块样强化,其中线状/导管样强化7例,斑片样强化5例,斑点状强化1例,另有3例为肿块样强化。16例患者TIC曲线均显示为Ⅱ型。Wash-in、Wash-out、TTP、MIPt及PEI五种灌注参数图的阳性发现分别为13个、10个、9个、15个、16个病灶,检出率分别为81.25%、62.50%、56.25%、93.75%、100%。对各组灌注参数值进行统计学分析,得出导管源性乳腺癌与对侧相应部位正常乳腺组织之间各参数值具有显著性差异(P<0.001);除TTP图参数外,病灶周边及病变中心各组参数值对比在统计学上亦具有显著性差异(P<0.001)。13例浸润性导管癌及3例导管内癌两种疾病的各种灌注参数值对比显示无统计学意义。结论:基于乳腺动态高分辨对比增强的T1WI定量灌注参数图对导管源性乳腺癌的检出率高,可为其诊断和鉴别诊断提供重要的补充信息。

Objective： To study the diagnostic value of quantitative T1WI MR parametric perfusion-weighted imaging based on DCE-MRI in duct-borne breast cancer. Methods： 16 cases of female were performed the DCE-MRI examination before surgical operation, and the time-intensity curve （TIC） were acquired, then the parameters perfusion images of Wash-in, Wash-out, TTP, MIPt and PEI were drawn out by the special software for breast. And then measured the parameters of perfusion, analyzed the features of perfusion of duct related breast cancers. Results： 13 cases invasive ductal carcinoma and 3 cases ductal carcinoma in situ were confirmed by pathology in the 16 cases. 13 cases were non-mass-like enhancement, such as 7 cases duct-like, 5 cases patchy, I case spot-like. Another 3 cases were mass enhancement. All of the 16 cases TIC were the type II. 13, 10, 9, 15 and 16 lesions were found in the five kinds of parametric images. The detection rates were 81.25%, 62.50%, 56.25%, 93.75% and 100%, respectively. We found the parameters between lesions and normal breast tissue were significant difference （P〈 0.001）. Moreover, the parameters between periphery and centre of lesions was also significant （P〈 0.001）, except in the TTP. But there＇s no significant difference between the invasive ductal carcinoma and the ductal carcinoma in situ. Conclusion： Quantitative T1W1 MR parametric perfusion-weighted imaging based on DCE-MRI has a high detection rate of the duct-borne breast cancers, and might provide important additional information for its diagnosis and differential diagnosis.