摘要
目的分析MRI-DWI对单纯乳腺导管原位癌(DCIS)、浸润性导管癌(IDC)的鉴别诊断价值。方法经医院伦理学会批准随机选取医院2017年1月至2020年4月收治乳腺癌患者80例,其中I DC患者42例,DCIS患者38例。先进行核磁共振成像(MRI)检查,再进行扩散加权成像(DWI)检查。观察比较DCIS和IDC内部强化特征、MRI-DWI信号特征、病变定量指标,绘制ROC曲线。结果38例DCIS患者中主要以无线状分布为主,显著多于IDC组(P<0.05);42例IDC患者主要以分支线状分布为主,显著多于DCIS组,(P<0.05);38例DCIS患者中簇环状/网格状结构清晰者22例,簇环状/网格状结构模糊,但能辨认者10例;42例IDC患者中,10例患者表现为簇环状/网格状结构模糊,病变信号较均匀,23例患者表现为簇环状/网格状结构消失,病变信号均匀(P<0.05)。38例DCIS患者中,5例MRI-DWI上未见信号异常,33例MRI-DWI表现为高信号影,T2脂肪抑制序列中8例表现异常;42例IDC患者中,2例MRI-DWI上未见信号异常,40例为信号不均匀,T2脂肪抑制序列中,12例为等信号,30例为高信号。IDC最大直径、ADCmax低于DCIS(P>0.05),IDC患者ADCmin低于DCIS(P<0.05),ADC DR高于DCIS(P<0.05)。联合ADCmin、表观扩散系数下降率(ADCDR)诊断AUC、约登指数、敏感度、特异度最高。结论MRI-DWI通过明确单纯乳腺导管原位癌、浸润性导管癌的内部强化特征、MRI-DWI信号特征,并与病变定量指标结果相结合从而提升其鉴别诊断价值。
Objective To investigate the value of MRI-DWI in the differential diagnosis of simple ductal carcinoma in situ(DCIS)and invasive ductal carcinoma(IDC)of the breast.Methods With the approval of the hospital ethics society,80 patients with breast cancer in our hospital from January 2017 to April 2020 were randomly selected,including 42 IDC patients and 38 DCIS patients.The internal enhancement cha racteristics,MRI-DWI signal cha racteristics and pathological lesion quantitative indexes of DCIS and IDC were observed and compared,and ROC curves were drawn.Results The 38 patients with DCIS were mainly distributed without linear distribution,which was significantly higher than that of the IDC group(P<0.05).42 patients with IDC were mainly distributed in branchlike lines,which was significantly higher than that of the DCIS group(P<0.05).Among the 38 patients with DCIS,22 had clear cluster-ring/grid-like structure,and 10 had fuzzy cluster-ring/grid-like structure,but could be recognized.Among the 42 patients with IDC,10 patients showed fuzzy cluster-ring/grid-like structu re with uniform lesion signal,while 23 patients showed disappea ra nce of cluste r-ring/grid-like struct u re with uniform lesion signal(P<0.05).Among the 38 patients with DCIS,5 showed no abnormal signal on MRI-DWI,33 showed high signal shadow on MRI-DWI,and 8 showed abnormal signal in T2 fat suppression sequence.Among the 42 IDC patients,2 showed no abnormal signal on MR-DWI,40 showed uneven signal,12 showed equal signal and 30 showed high signal in T2 fat suppression sequence.The maximum diameter and ADCmax of IDC were lower than DCIS(P>0.05),ADCmin of IDC patients was lower than DCIS(P<0.05),and ADCDR was higher than DCIS(P<0.05).The AUC,Yoden index,sensitivity,and specificity of ADCmin and ADCDR were the highest.Conclusion MRI-DWI can enhance the value of differential diagnosis by cla rifying the internal enhancement cha racteristics and MRA-DWI signal characteristics of simple ductal carcinoma in situ and invasive ductal carcinoma of the breast,an
作者
袁秀华
王刚
李德维
YUAN Xiu-hua;WANG Gang;LI De-wei(Department of Radiology,Dongguan People's Hospital,Dongguan 523000,Guangdong Province,China)
出处
《中国CT和MRI杂志》
2021年第4期43-45,149,共4页
Chinese Journal of CT and MRI
关键词
MRI-DWI
乳腺导管原位癌
浸润性导管癌
鉴别
MRI-DWI
Ductal Carcinoma in Situ of the Breast
Invasive Ductal Carcinoma
Differentiation
