乳腺磁共振扩散加权成像在确定乳腺癌肿瘤边界中的应用

Application of breast magnetic resonance diffusion-weighted imaging in determining breast cancer tumor boundaries

目的探讨乳腺磁共振扩散加权成像在确定乳腺癌肿瘤边界中的效果。方法选择本院2020年6月至2021年7月诊治的42例乳腺癌可疑者为研究对象,通过乳腺磁共振扩散加权成像技术来分析乳腺癌肿瘤边界情况,对比不同MRI序列扫描时对应的乳腺肿瘤影像学特征,对比不同病理类型乳腺肿瘤对应的ADC值,对比肿瘤周围组织与肿瘤组织间ADC值。结果b=500时,恶性肿瘤中,ADC=(1.08±0.023)×10^(-3)mm^(2)/s,其中导管原位癌中ADC=(0.96±0.035)×10^(-3)mm^(2)/s,浸润性导管癌中ADC=(1.04±0.019)×10^(-3)mm^(2)/s,乳腺肉瘤中ADC=(1.79±0.020)×10^(-3)mm^(2)/s,乳腺肉瘤者对应的ADC值明显高于其他类型恶性肿瘤者,其差异存在统计学意义(P<0.05)。方向相同层面不同时肿瘤周围组织与肿瘤组织间ADC值对比发现肿瘤组织ADC值随组织向外逐渐增加,并且高于周围组织对应的ADC值,差异存在统计学意义(P<0.05);距离肿瘤组织最近一层对应ADC值高于其他层次,差异存在统计学意义(P<0.05)。结论乳腺磁共振扩散加权成像用于确定乳腺癌肿瘤边界时,ADC值具有一定的特异性与敏感性,可为临床治疗提供重要的信息,保障临床鉴别的准确性,值得推广。

Objective To evaluate the effect of diffusion-weighted imaging(Dwi)in determining the boundary of breast cancer.Methods 42 Suspected Cases of breast cancer diagnosed and treated in our hospital from June to July 2020 were selected as the study subjects.The boundary of breast cancer was analyzed by diffusion weighted imaging,the imaging characteristics of breast tumors in different MRI sequences were compared,the ADC values in different pathological types of breast tumors were compared,and the ADC values between the surrounding tissues and tumor tissues were compared.Results At B=500,ADC=(1.08±0.023)×10^(-3)mm^(2)/s in malignant tumors,ADC=(0.96±0.035)×10^(-3)mm^(2)/s in ductal carcinoma in situ,ADC=(1.04±0.019)×10^(-3)mm^(2)/s in invasive ductal Carcinoma,and ADC=(1.79±0.020)×10^(-3)mm^(2)/s in breast sarcoma,the ADC values of breast sarcomas were significantly higher than those of other types of malignant tumors(P<0.05).In the same direction,the ADC values between the tumor and the surrounding tissue were higher than those of the surrounding tissue(P<0.05);The ADC values in the closest layer of tumor tissue were significantly higher than those in other layers(P<0.05).Conclusion WHEN DWI is used to determine the tumor boundary of Breast Cancer,ADC value has certain specificity and sensitivity,which can provide important information for clinical treatment and ensure the accuracy of clinical differentiation.