乳腺癌MRI影像学特征及其与前哨淋巴结和腋窝淋巴结转移的关系

MRI features of breast cancer and their relationship with sentinel lymph node and axillary lymph node metastasis

目的分析乳腺癌MRI影像学特征及其与前哨淋巴结和腋窝淋巴结转移的关系。方法选择我院2019年5月~2022年5月收治的117例乳腺癌患者作为研究对象,其中前哨淋巴结结转移41例,腋窝淋巴结转移34例,无转移42例;对患者行乳腺癌MR扫描检查;绘制ROC曲线分析诊断腋窝淋巴结转移和前哨淋巴结转移的价值。结果乳腺癌前哨淋巴结转移、腋窝淋巴结转移患者MRI影像学检查的短长径比低于无转移者,相对表观扩散系数(rADC)值高于无转移,差异有统计学意义(P<0.05);乳腺癌前哨淋巴结转移、腋窝淋巴结转移和无转移患者环形强化情况的差异有统计学意义(P<0,05);乳腺癌MRI影像学特征联合应用预测前哨淋巴结模型为Log(P)=-0.602×短长径比+0.675×rADC-0.754×环形强化+0.895;乳腺癌MRI影像学特征联合应用预测腋窝淋巴结转移模型为Log(P)=-0.685×短长径比+0.712×rADC-0.695×环形强化+0.794;短长径比、rADC、环形强化三指标联合应用预测乳腺癌前哨淋巴结转移的AUC高于各指标单独应用,差异有统计学意义(P<0.05);短长径比、rADC、环形强化三指标联合应用预测腋窝淋巴结转移的AUC高于各指标单独应用,差异有统计学意义(P<0.05)。结论乳腺癌MRI影像学特征与前哨淋巴结和腋窝淋巴结转移高度相关,且MRI影像学特征联合应用可显著有效预测前哨淋巴结转移和腋窝淋巴结转移。

Objective To explore the MRI imaging features of breast cancer and its relationship with sentinel lymph node and axillary lymph node metastasis.Methods A total of 117 patients with breast cancer admitted to our hospital from May 2019 to May 2022 were selected as the study objects,including 41 patients with sentinel lymph node metastasis,34 with axillary lymph node metastasis and 42 without metastasis.The patients underwent MRI scan for breast cancer.ROC curve was drawn to analyze the diagnostic value of axillary lymph node metastasis and sentinel lymph node metastasis.Results Breast cancer patients with sentinel lymph node metastasis and axillary lymph node metastasis had significantly lower ratio of ratio of short diameter to long diameter in MRI imaging than those without metastasis.The relative apparent diffusion coefficient(rADC)value was significantly higher than that without metastasis(P<0.05).There were significant differences in ring enhancement between patients with sentinel lymph node metastasis,axillary lymph node metastasis and those without metastasis(P<0.05).The prediction model of sentinel lymph node by combined application of MRI features of breast cancer was Log(P)=-0.602×ratio of short diameter to long diameter+0.675×rADC-0.754×ring enhancement+0.895.The combined application of MRI features to predict axillary lymph node metastasis was Log(P)=-0.685×ratio of short diameter to long diameter+0.712×rADC-0.695×ring enhancement+0.794.The combined application of ratio of short diameter to long diameter,rADC and ring enhancement in predicting the AUC of sentinel lymph node metastasis was significantly higher than that applied alone,and the difference was statistically significant(P<0.05).Combined application of ratio of short diameter to long diameter,rADC and ring enhancement was significantly higher in predicting axillary lymph node metastasis AUC than that applied alone,and the difference was statistically significant(P<0.05).Conclusion MRI imaging features of breast cancer are highly correlated with sentinel and axillary lymph node metastasis.The combined application of MRI imaging features can significantly and effectively predict sentinel lymph node metastasis and axillary lymph node metastasis.