乳腺癌淋巴血管浸润的MRI 影像研究

MRI study of lymphatic vascular invasion in breast cancer patients

目的分析乳腺癌患者淋巴血管浸润的磁共振成像(MRI)影像特征。方法采用回顾性分析法,对2020年6月—2022年6月期间郑州大学附属肿瘤医院收治的80例乳腺癌患图像展开分析。依据患者的术前MR检查和术后病理证实的淋巴血管浸润情况分为浸润组(n=25)和非浸润组(n=55)。比较两组临床资料及MRI征象、MRI表现、时间-强度曲线(TIC)类型,并分析MRI诊断效能。结果与非浸润组相比,浸润组患者腋窝淋巴结肿大、瘤周水肿的占比升高,ADC值降低,差异有统计学意义(P<0.05)。与非浸润组相比,浸润组患者的MRI边缘毛刺、边缘模糊、内部坏死的占比升高,差异有统计学意义(P<0.05)。与非浸润组相比,浸润组患者TICⅢ型的占比升高,差异有统计学意义(P<0.05)。以病理检测结果为金标准,MRI检查时发现乳腺癌淋巴血管浸润性病灶27个,占比31.40%,非浸润性病灶59个,占比68.60%。MRI诊断符合度、灵敏度、特异度分别为88.89%、93.22%、91.86%,结论MRI对于乳腺癌患者淋巴血管浸润有一定诊断价值,患者多表现出腋窝淋巴结肿大、瘤周水肿、ADC值降低和MRI边缘毛刺、模糊、内部坏死,同时对于TICⅢ型患者也应加强监测。

Objective To analyze the magnetic resonance imaging(MRI)features of lymphatic vascular invasion in breast cancer patients.Methods Totally 80 cases of breast cancer from June 2020 to June 2022 were analyzed retro⁃spectively.The patients were divided into invasive group(n=25)and non-invasive group(n=55)according to the lymphatic vessel infiltration confirmed by preoperative MR examination and postoperative pathology.The clinical data,MRI signs,MRI manifestations,time-intensity curve(TIC)types of the two groups were compared,and the diag⁃nostic efficacy of MRI was analyzed.Results Compared with the non-invasive group,the proportion of axillary lymph node enlargement and peritumoral edema in the invasive group increased,and the ADC value decreased,the difference was significant(P<0.05).Compared with the non-invasive group,the proportion of MRI edge burr,edge blur,and internal necrosis in the invasive group increased significantly(P<0.05).Compared with the non-invasive group,the proportion of patients with TIC type III in the invasive group increased significantly(P<0.05).Based on the pathological examination results as the gold standard,27 cases of lymphovascular invasive lesions of breast cancer were found on MRI,accounting for 31.40%,and 59 cases of non invasive lesions,accounting for 68.60%.The diagnostic accuracy,sensitivity and specificity of MRI were 88.89%,93.22%and 91.86%respec⁃tively.Conclusion MRI has certain diagnostic value for lymphatic vascular invasion in patients with breast cancer.Most patients show axillary lymph node enlargement,peritumoral edema,decreased ADC value,and MRI edge burrs,blurring,and internal necrosis.At the same time,the monitoring of TICⅢpatients should also be strengthened.