7.0T MRI对离体乳腺癌组织浸润范围判定的病理对照研究

The evaluation of the infiltration range of breast cancer tissue in vitro using 7.0 T MRI: a comparative study between MRI and histological examination

目的评估MRI技术判定乳腺癌肿瘤边界的准确性,验证MRI技术在手术前判断乳腺癌浸润范围的价值。材料与方法新鲜乳腺离体标本17个,离体后迅速行MR扫描及病理检查,在7.0 T MR成像仪上采集乳腺癌离体样本的MR T1WI、T2WI和扩散加权成像(DWI)。通过Vnmr J 4.0计算出表观扩散系数像(ADC)及各向异性分数像(FA)。在Vnmr J 4.0软件上对DWI、ADC和FA图通过手工勾绘病变范围,并计算病变面积。在显微镜下标记病理切片的病变范围,通过Photoshop软件计算病变面积,最后比较上述图像的病变范围与病理染色切片的病变范围差异。结果在送检的乳腺癌标本中,经病理证实14例为乳腺浸润性导管癌,2例为乳头状癌,1例为黏液腺癌。结合不同序列的MRI可观察到乳腺肿瘤边缘的浸润范围。经过spss19.0软件分析,发现MR DWI、ADC及FA像的病变面积与病理标本浸润范围具有显著的相关性;DWI平均面积[(4.32±1.28)cm2]与病理平均面积[(3.81±1.12)cm2]比较,r=0.966,P<0.01;ADC平均面积[(4.68±1.43)cm2]与病理平均面积[(3.81±1.12)cm2]比较,r=0.976,P<0.01;FA平均面积[(4.74±1.53)cm2]与病理平均面积[(3.81±1.12)cm2]比较,r=0.964,P<0.01)。结论 7.0 T MRI ADC图和FA图在评估肿瘤浸润范围具有更明显的价值,病变面积与病理结果有很高的相关性,可为乳腺癌术前病变范围评估提供重要的参考信息。

Objectives：To evaluate the accuracy of inifltration range of breast cancer tissue in vitro using 7.0 T magnetic resonance imaging（MRI）, and to verify the possible value of determining the breast tumor margin before surgery by MRI. Materials and Methods：Fresh breast cancer tissue in vitro （n=17） were underwent 7.0 T MRI and histological examination. After acquisition of diffusion weighted imaging （DWI）、apparent diffusion coefficient （ADC） and fractional anisotropy （FA） imaging on the 7.0 T MRI machines, the edge of lesion was drawn out manually and the area of tumor was calculated by VnmrJ 4.0. The HE dyeing slice of pathology was observed under a microscope. The edge of lesion was drawn out manually and the area was calculated by Photoshop software. The correlation between the area of tumor from MRI and the histological slice was analyzed using Pearson correlation test of SPSS version 19.0. Results：In all specimens, there were 14 cases of breast inifltrative ductal carcinoma, 2 cases breast papillary carcinoma and 1 case of mucinous breast carcinoma conifrmed pathologically. Signiifcant correlation was found between the area of breast tumor on DWI, ADC, FA mapping and histological result （4.32±1.28） cm2 in DWI vs. （3.81±1.12）cm2 in histological slice, Pearson correlation coefifcient r=0.966, P=0.00, （4.68±1.43） cm2 in ADC vs. （3.81± histological slice, Pearson correlation coefifcient r=0.976, P=0.00, （4.74±1.53） cm2 in FA vs. （3.81±1.12） cm2 in histological slice, Pearson correlation coefifcient r=0.964, P=0.00）. Conclusions：Although all of the areas acquired by MRI were larger than those by histological results, there was signiifcant correlation between them. Thus, useful information for evaluating the inifltration range of breast tumor may be provided by MRI. 1.12） cm2 in histological slice, Pearson correlation coefficient r=0.976, P=0.00, （4.74±1.53） cm2 in FA vs. （3.81±1.12） cm2 in histological slice, Pearson correlation coefficient r=0.964, P=0.00）. Conclusions： Although all of the areas acquired by MRI were larger than those by histological results, there was significant correlation between them. Thus, useful information for evaluating the infiltration range of breast tumor may be provided by MRI.