TIC类型及ADC值在乳腺疾病中的诊断价值

Value of time-signal intensity curve and ADC values in the diagnosis of breast diseases

目的探讨MR动态增强曲线(TIC)类型和弥散表观系数(ADC)值在乳腺疾病中的诊断价值。方法回顾性分析2008年5月至2014年5月间经病理证实的107例乳腺疾病女性患者的临床资料,对病灶进行TIC类型分析及其ADC值的测量,并与对侧乳腺的相应正常区域做对照,探讨TIC类型与ADC值在乳腺癌病理分级中的诊断价值。结果 108个乳腺病灶经病理证实良性病变49例,恶性病变59例,其中36例具有病理分级。良性病变曲线分布Ⅰ型33例、Ⅱ型8例、Ⅲ型8例,恶性病变曲线分布Ⅰ型12例、Ⅱ型14例、Ⅲ型33例,乳腺癌Ⅰ级8例、Ⅱ级21例、Ⅲ级7例,TIC类型分布在乳腺良恶性病灶间差异具有统计学意义(P<0.05),在乳腺癌病理分级间差异无统计学意义(P>0.05)。正常乳腺与不同病理分级乳腺癌ADC值多组间两两比较,正常乳腺组织ADC值为(1.89±0.061)×10-3mm2/s,乳腺癌病理组织Ⅰ级为(1.09±0.122)×10-3mm2/s,乳腺癌病理组织Ⅱ级为(0.579±0.067)×10-3mm2/s,乳腺癌病理组织Ⅲ级为(0.203±0.648)×10-3mm2/s,各组间比较差异均有显著统计学意义(P<0.01)。乳腺癌病理组织学分级与其呈负相关(r=-0.969,P=0.000)。结论 TIC类型对乳腺良恶性病变鉴别诊断具有重要应用价值,乳腺癌的ADC值可以预测乳腺癌的恶性程度,但MR动态增强曲线类型对乳腺癌病理分级的预测有一定难度。

Objective To investigate the value of time-signal intensity curve(TIC) and apparent diffusion coefficient(ADC) values in the diagnosis of breast diseases. Methods The clinical data of 107 patients with breast diseases confirmed by pathology from May 2008 to May 2014 were retrospectively reviewed. TIC types of disease were analyzed and ADC values were measured, which were then compared with the data of the corresponding normal regions of the contralateral breast. Diagnostic value of TIC and ADC values in pathological classification of breast cancer was investigated. Results The pathological results showed benign lesions in 49 cases and malignancy in 59 cases. There are 36 patients with pathological grading among them. Benign lesions curve distribution showed 33 cases of type Ⅰ, 8 cases of type Ⅱ, 8 cases of type Ⅲ, and malignant lesions curve distribution showed 12 cases of typeⅠ, 14 cases of type 2, 33 cases of type Ⅲ, 8 cases of breast cancer in gradeⅠ, 21 cases of breast cancer in grade Ⅱ, 7 cases of breast cancer in grade Ⅲ. TIC type distribution in benign and malignant breast lesions had statistically significant difference(P<0.05).There was no significant difference in TIC type distribution between the pathological grading of breast cancer(P>0.05).The ADC values of normal breast and different histopathologic classification of breast cancer were compared. The results showed that the ADC values of normal mammary tissue, the pathological tissue of breast cancer in gradeⅠ, the pathological tissue of breast cancer in grade Ⅱ, and the pathological tissue of breast cancer in grade Ⅲ were(1.89±0.061)×10-3mm2/s,(1.09±0.122)×10-3mm2/s,(0.579±0.067)×10-3mm2/s,(0.203±0.648)×10-3mm2/s, respectively, with significant difference between the groups(P<0.01). The histological grade of breast cancer was negatively correlated with ADC values(r=-0.969, P=0.000). Conclusion TIC type has important application value in the diagnosis of benign and malignant breast lesions. ADC values of breast cancer can predict the degree of malignancy of breast cancer, but TIC type has certain difficulty in predicting pathological classification of breast cancer.