浸润性乳腺癌患者非肿块强化和肿块强化的动态增强MRI特征分析

Analysis dynamic contrast-enhanced MRI features of non-tumor-enhanced and tumor-enhanced invasive breast cancer

目的探讨分析动态增强MRI特征为非肿块强化和肿块强化的浸润性乳腺癌患者影像特征。方法选取浸润性乳腺癌患者55例,行乳腺动态增强MRI检查显示为非肿块强化和肿块强化患者,分别作为观察组和对照组均经手术或病理活检证实,评估两组表观扩散系数(ADC)值、早期强化率、肿块边界清晰、增强平台类型,病灶大小、雌激素受体(ER)、人表皮生长因子受体-2(HER-2)阳性、T分期、N分期结果。结果观察组表观扩散系数(ADC)值为(1.29±0.20)×10^(-3) mm^(2)/s,高于对照组(0.89±0.18)×10^(-3) mm^(2)/s,差异具有统计学意义(P<0.05),观察组肿块边界不清晰发生率为80.52%,高于对照组20.59%,差异具有统计学意义(P<0.05),观察组病灶体积为(25.50±4.21)cm^(3),高于对照组(16.65±3.92)cm^(3),差异具有统计学意义(P<0.05),观察组HER-2阳性率为76.19%,高于对照组26.47%,两组T分期、N分期比较,差异具有统计学意义(P<0.05)。结论对非肿块强化和肿块强化浸润性乳腺癌患者,动态增强MRI通过多参数、多方位成像进行鉴别,非肿块强化病灶ADC值、边界不清晰发生率及ER、HER-2阳性率表现为增高。

Objective For the invasive breast cancer patients with non-mass enhancement and mass enhancement with Dy‐namic enhanced MRI,to analyze the clinical and imaging features so as to provide evidence for clinical diagnosis and treatment.Methods 55 patients with invasive breast cancer by dynamic enhanced MRI were selected from January in 2019 to November in 2023,they were selected as study group and control group,with 21 cases in study group and 34 cases in control group,which were confirmed by surgery or pathological biopsy.Apparent diffusion coefficient(ADC),early enhancement rate,clear tumor boundary,type of enhancement platform,lesion size,estrogen receptor(ER),positive human epidermal growth factor receptor2(HER-2),T-stage and N-stage results were evaluated in both groups.Results The apparent diffusion coefficient(ADC)of the study group was(1.29±0.20)×10^(-3) mm^(2)/s,which was higher than that of the control group(0.89±0.18)×10^(-3) mm^(2)/s,the dif‐ference was statistically significant(P<0.05).The incidence of lumpy boundary ambiguity in the study group was 80.52%,higher than that of the control group by 20.59%,the difference was statistically significant(P<0.05).The volume of lesion in the study group was(25.50±4.21)cm^(3),higher than the control group(16.65±3.92)cm^(3),the difference was statistically signifi‐cant(P<0.05).The positive rate of HER-2 in the study group was 76.19%,higher than the control group 26.47%.Comparison of T stage and N stage between two groups,the difference was statistically significant(P<0.05).Conclusion For patients with non-tumor enhancement and invasive breast cancer with tumor enhancement,dynamic enhanced MRI was used to distinguish them by multi-parameter and multi-directional imaging,and ADC value,incidence of borderline ambiguity and positive rate of ER and HER-2 in non-tumor enhancement lesions were increased.