乳腺癌MRI征象与病理特征的关系

Relationship between MRI features and pathological features of breast cancer

目的探讨乳腺癌的MRI征象和病理特征的关系。方法选取2014年2月至2016年2月在昆山市第一人民医院治疗的乳腺癌168例共180个病灶,分析MRI图像与病理类型及组织学分化程度关系,同时测量表观扩散系数(ADC)值。结果浸润性导管癌MRI表现为边缘有毛刺、边界模糊及内部有坏死的比例分别为57.69%、84.62%和55.13%,明显高于其他类型乳腺癌的16.67%、8.33%和16.67%,差异有统计学意义(P<0.05);组织学Ⅰ级病灶MRI表现为边缘无毛刺、边界清楚及内部无坏死的比例分别为76.47%、70.59%和94.12%,明显高于组织学Ⅱ级和Ⅲ级病灶的41.94%和36.36%、1.61%和27.27%、40.32%和36.63%,差异均有统计学意义(P<0.05);浸润性导管癌ADC值为(1.082±0.033)×10^(-3)mm^2/s,明显低于其他类型乳腺癌(1.204±0.027)×10^(-3)mm^2/s,差异有统计学意义(P<0.05);组织学Ⅲ级病灶ADC值为(1.012±0.030)×10^(-3)mm^2/s,明显低于组织学Ⅰ级和Ⅱ级病灶[(1.153±0.061)×10^(-3)mm^2/s、(1.147±0.041)×10^(-3)mm^2/s],差异有统计学意义(P<0.05)。结论乳腺癌MRI形态学特征以及ADC值为乳腺癌术前病理分型评估可能有参考价值。

Objective To investigate the relationship between magnetic resonance imaging（MRI） features and pathological features of breast cancer. Methods A to tal of 168 patients with breast cancer with 180 lesions, who admitted to our hospital from February 2014 to February 2016, were selected. The relationships between MRI and pathological type and histological differentiation were analyzed, and the apparent diffusion coefficient（ADC） values were measured. Results The proportion of edge burr, boundary blur and internal necrosis in MRI findings of invasive ductal carcinoma were respectively 57.69% , 84.62% and 55.13% , which were significantly higher than 16.67% , 8.33% and 16.67% of other types of breast cancer（P0.05）. The proportion of no edge burr, clear boundary and no necrosis in MRI features of Ⅰ grade lesion of histology were respectively 76.47% , 70.59% and 94.12% , which were significantly higher than 41.94% , 1.61% and 40.32% of the Ⅱ grade lesion of histology and 36.36% , 27.27% and 36.63% of Ⅲ grade lesion of histology（P0.05）. The ADC value of invasive ductal carcinoma was （1.082±0.033）×10^（-3）mm^2/s, which was significantly lower than（1.204±0.027）×10^（-3）mm^2/s of other types of breast cancer（P0.05）. The ADC value of Ⅲ grade lesion of histology was （1.012±0.030）×10^（-3）mm^2/s, which was significantly lower than（1.153±0.061）×10^（-3）mm^2/s of Ⅰ grade lesion of histology and （1.147±0.041）×10^（-3）mm^2/s of Ⅱ grade lesion of histology（P0.05）. Conclusion The MRI morphological characteristics and ADC value of breast cancer can provide some help for the evaluation of preoperative pathological types of breast cancer.