Her-2过表达型乳腺癌磁共振-扩散加权成像及动态增强成像分析

Diffusion Weighted Imaging and Dynamic Contrast-Enhanced MR Imaging Features of Her-2 Over Expression Subtype of Breast Cancer

目的探讨Her-2过表达型乳腺癌磁共振-扩散加权成像(MR-DWI)及动态增强成像表现。方法收集我院经病理学证实的18例Her-2过表达型乳腺癌及36例非Her-2过表达型乳腺癌病例。术前均进行3.0T高场MR-DWI及动态增强扫描,记录并分析病灶MR表现。结果 18例Her-2过表达型乳腺癌中,61.1%(11/18)表现为边缘毛刺征;55.6%(10/18)增强后表现不均匀强化;44.4%(8/18)伴有腋窝淋巴结转移,并且与非Her-2过表现组之间差异有统计学意义(P<0.05)。b值为400、800、1000 s/mm^2,Her-2过表达型乳腺癌病灶的平均表观扩散系数(Apparent Diffusion Cofficent,ADC)值分别为(1.498±0.23)×10^(-3)、(1.317±0.21)×10^(-3)、(1.232±0.19)×10^(-3) mm^2/s,非Her-2过表达组乳腺癌病灶的平均ADC值分别为(1.234±0.28)×10^(-3)、(1.053±0.25)×10^(-3)、(0.944±0.21)×10-3 mm^2/s。并且在b为800 s/mm^2时,与非Her-2过表达组之间的差异具有统计学意义(P<0.05)。结论 MRI边缘毛刺征、不均匀强化、相对较高的ADC值对Her-2过表达型乳腺癌的诊断有参考意义,且Her-2过表达型乳腺癌更易发生腋窝淋巴结转移。

Objective To investigate the dynamic contrast-enhanced MR imaging（DCE-MRI） and diffusion-weighted imaging（DWI） features of Her-2 over expression subtype of breast cancers.Methods Altogether 18 cases of Her-2 over expression subtype of breast cancers and 36 cases of breast cancer without Her-2 over expression confirmed pathologically in the hospital were collected. All the cases were examined by using 3.0T DCE-MRI and DWI. The DCE-MRI and DWI features of Her-2 over expression subtype of breast cancer were recorded and analyzed. Results Among 18 cases of Her-2 over expression subtype of breast cancer, the speculated margin signs took up 61.1%（11/18）; postenhanced heterogeneous enhancement signs accounted for 55.6%（10/18）; there were 44.4%（8/18） lesions with lymph node metastasis. Statistically significant differences were seen between the margin, the way of enhancement and lymph node metastasis of the Her-2 over expression breast cancer and the breast cancer without Her-2 over expression（P0.05）. When the b value was 400, 800 and 1000 s/mm^2, the ADC value of the Her-2 over expression subtype breast cancers were（1.498±0.23） ×10^（-3）,（1.317±0.21）×10-3,（1.232±0.19）×10^（-3） mm^2/s, and the ADC value of the breast cancers without Her-2 over expression were（1.234±0.28）×10^（-3）,（1.053±0.25）×10-3,（0.944±0.21）×10^（-3） mm^2/s. When the b value was 800 s/mm^2, there was statistically significant difference between the Her-2 over expression type breast cancers and the breast cancer without Her-2 over expression（P〈0.05）. Conclusion DCE-MRI features such as the speculated margin signs, heterogeneous enhancement and the ADC values were useful for the diagnosis of Her-2 over expression subtype breast cancer. The lymph node metastases were more frequently found in Her-2 over expression subtype breast cancer.