磁共振体素内不相干运动成像在乳腺癌分级中的应用

Application of intravoxel incoherent motion on the grading of breast cancer

目的探讨基于体素内不相干运动成像(intravoxel incoherent motion,IVIM)理论的单指数和双指数模型与乳腺癌组织学分级的相关关系。方法选取千佛山医院2014年10月~2016年1月临床拟诊为乳腺癌女性患者46例,术前均行乳腺MR扫描,将扫描所得图像传至后处理工作站,用单指数和双指数模型分别测量乳腺肿块的慢速扩散系数、快速扩散系数和灌注分数。各参数值利用单因素方差分析进行比较,然后采用秩相关分析乳腺癌分级与不同参数之间的关系。结果最终经手术病理证实乳腺癌Ⅰ级8例,Ⅱ级15例,Ⅲ级10例。乳腺癌Ⅰ、Ⅱ、Ⅲ级之间相比较,单指数和双指数模型分别测得的Dmono值、D*mono值和Dbi值、D*bi值组间差异存在统计学意义,而fmono值和fbi值组间差异无统计学意义,并且乳腺癌分级与Dmono值和Dbi值呈负相关,与D*mono值和D*bi值呈正相关。结论体素内不相干运动成像可以用于预测乳腺癌的组织学分级。

Objective To explore the correlation between the grading of breast cancer and the mono-exponential and bi-expo- nential model based on the intravoxel incoherent motion. Methods We selected forty-six of female breast cancer patients from Qianfoshan Hospital from October 2014 to January 2016. All patients underwent breast MR scan before operation and the images were transferred to postprocessing workstation. And we used the monoexponential and biexponential model to measure the slow ADC, fast ADC and the fraction of fast ADC, and used the One-Way ANOVA to analyze different parameters. Then, the correla- tion coefficient was applied to analyze the relationship between different parameters and the grading of breast cancer. Results According to surgery and pathology, the patients were divided into grade I （eight cases）, grade II （fifteen cases） and grade III （ ten cases）. To compare the histological grade I, II and III in breast cancer, the parameter of Dmono, D^＊ mono, Dbi and D^＊ bi had statistically significant differences between the different grades. But the parameter of fmono and fbi had no statistically signifi- cant differences between the different grades. And grade I, II and III in breast cancer had negative correlation with Dmono and Dbi while it had positive correlation with D^＊ mono and D^＊ hi. Conclusion Intravoxel incoherent motion can be used to predict the grading of breast cancer.