WB-DWI对于乳腺癌患者术后临床评价

WB-DWI for the Postoperative Clinical Evaluation of Breast Cancer Patients

目的:研究核磁共振全身弥散加权成像(WB-DWI)在乳腺癌患者术后随访评价中的应用价值。方法:选取2020年5月-2023年6月在我院接受手术治疗的乳腺癌患者200例为对象,均在本院接受乳腺癌全切术治疗,术后定期随访中分别进行WB-DWI检查,并以术后病理随访结果为金标准,计算WB-DWI检查对乳腺癌术后复发、远处转移、腋窝淋巴结转移的诊断价值。结果:WB-DWI对乳腺癌术后复发或远处转移的诊断准确率、灵敏度和特异度分别为97.00%、97.44%、96.72%;WB-DWI对术后腋窝淋巴结转移的诊断准确率、灵敏度和特异度分别为94.00%、90.53%、97.14%;转移性淋巴结的ADC值明显低于非转移性淋巴结的ADC值(P<0.05),且ADC值对腋窝淋巴结转移的最佳诊断阈值为0.895×10^(-3)mm^(2)/s,AUC值为0.795;不同骨组织转移灶的ADC值明显低于正常骨组织的ADC值(P<0.05),且ADC值对骨转移的最佳诊断阈值为0.983×10^(-3)mm^(2)/s,AUC值为0.834。结论:乳腺癌术后的临床评价中应用WB-DWI检查具有快速、无创、无需造影剂、安全、无辐射、可短期重复扫描等优点,能得到类似PET-CT图像,敏感度高,能早期检出转移灶和复发灶,为乳腺癌术后复发和转移的早期发现提供可靠的信息,值得推广应用。

Objective:To study the value of MRI whole body diffusion weighted imaging(WB-DWI)in postoperative follow-up evaluation of breast cancer patients.Methods:200 patients of breast cancer who received surgical treatment in our hospital from May 2020-June 2023 were selected as subjects,They all received total breast cancer resection in our hospital.WB-DWI examination were performed during postoperative follow-up,and the postoperative pathological follow-up results were used as the gold standard to calculate the WB-DWI diagnosis of postoperative recurrence,distant metastasis,axillary lymph node metastasis.Results:the diagnostic accuracy,sensitivity and specificity of WB-DWI for postoperative recurrence or distant metastasis of breast cancer were 97.00%,97.44%and 96.72%,respectively;the diagnostic accuracy,sensitivity and specificity of WB-DWI for postoperative axillary lymph node metastasis were 94.00%,90.53%and 97.14%,respectively;the ADC of metastatic lymph nodes was significantly lower than the ADC of non-metastatic lymph nodes(P<0.05).Moreover,the optimal diagnostic threshold of ADC value for axillary lymph node metastasis was 0.895×10^(-3)mm^(2)/s,The AUC value was0.795;the ADC value of different bone tissue metastasis was significantly lower than the ADC value of normal bone tissue(P<0.05).Moreover,the optimal diagnostic threshold of ADC value for bone metastasis was 0.983×10^(-3)mm^(2)/s,and the AUC value was 0.834.Conclusion:WB-DWI application in clinical evaluation of breast cancer has the advantages of rapidness,non-invasive,non-contrast,safety,no radiation,and short-term repeat scanning.It can get images similar to PET-CT images,and has high sensitivity,and can detect metastasis and recurrence leision early.It provides reliable information for early detection of recurrence and metastasis of breast cancer and is worthy of promotion and application.