乳腺纤维腺瘤中医辩证分型与MRI影像学表现特点的关系研究

Study on Relationship Between TCM Syndrome Differentiation and MRI Imaging Features of Fibroadenoma of Breast

目的研究乳腺纤维腺瘤(FA)中医辩证分型与MRI影像学表现特点的关系。方法选取2016年12月至2019年12月我院104例FA患者为样本,根据中医辨证分型分为肝郁气滞和痰湿凝结两组,分别进行横断位T_(1)WI、抑脂T_(2)加权成像(fs-T_(2)WI)、扩散加权成像(DWI)和动态增强扫描(DCE)等序列检查并比较结果。结果两组T_(1)WI均表现为低信号影,T_(2)WI均可见高、中、低信号及混杂信号且两组比较差异无统计学意义(P>0.05);两组DWI形状不规则、边界模糊和强化不均匀比较无明显差异(P>0.05);两组TIC分型均以Ⅰ型为主,占比分别为95.35%和68.85%(P<0.05),痰湿凝结证型Ⅱ型(21.31%)和Ⅲ型(9.84%)占比明显高于肝郁气滞证型(P<0.05);肝郁气滞型FA病灶ADC值高于痰湿凝结型,K^(trans)、K_(ep)和V_(e)均低于痰湿凝结型,差异有统计学意义(P<0.05)。结论不同证型FA病灶MRI形态特征无明显差异,但DWI和DCE扫描多项定量指标可为FA中医辨证分型提供客观依据。

Objective To study the relationship between TCM syndrome differentiation and MRI imaging features of fibroadenoma of breast(FA).Methods From December 2016 to December 2019,104 FA patients in our hospital were selected as samples,and they were divided into liver qi stagnation group and phlegm-damp coagulation group according to TCM syndrome differentiation.The cross-sectional T1WI,fat-suppressing T_(2)-weighted imaging(fs-T_(2)WI),diffusion-weighted imaging(DWI)and dynamic contrast enhancement(DCE)sequences were performed on all patients,and the results were compared.Results T_(1)WI in the two groups showed low-signal shadow,and T_(2)WI showed high,medium,low signals and mixed signal,and the differences between the two groups were not statistically significant(P>0.05).There were no significant differences in the irregular shapes,blurred boundaries and uneven enhancement in the DWI in the two groups(P>0.05).The TIC classification of the two groups was mainly type Ⅰ,accounting for 95.35%and 68.85%respectively(P<0.05).The proportions of typeⅡ(21.31%)and typeⅢ(9.84%)of phlegm-damp coagulation syndrome were significantly higher than those of liver qi stagnation syndrome(P<0.05).The ADC value of FA lesions of liver qi stagnation syndrome was higher than that of phlegm-damp coagulation syndrome while the K^(trans),K_(ep) and V_(e) were all lower than those of phlegm-damp coagulation syndrome(P<0.05).Conclusion There is no obvious difference in MRI morphological features of FA lesions of different syndrome types,but multiple quantitative indicators of DWI and DCE scans can provide an objective basis for TCM syndrome differentiation of FA.