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MRI对乳腺癌腋窝淋巴结转移的诊断价值

         

摘要

Objective To estimate the diagnostic value of MRI in lymph node metastasis in breast cancer patients. Methods A total of 52 breast cancer patients confirmed by surgery were retrospectively analyzed to explore the feature of metastatic lymph nodes. Results The amount of lymph node metastasis, the length of short diameter and the eara of cross-section area were significantly increased compared with that of the non-metastatic lymph nodes (P<0.05), but there is no significant difference in the ratio of long/short diameter, apparent diffusion coefficient (ADC) value, time-intensity curve (TIC), maximal slope of increase (MSI) and signal enhancement ratio (SER) (P>0.05). The size of the primary breast mass in metastatic group was larger and the ADC value was lower than that of non-metastatic group (P<0.05). However, there was no significant difference in the type of TIC, MSI, SER of the breast mass between the two groups (P>0.05). In the metastatic lypmh nodes, there was no significant correlation of TIC and MSI about the breast mass and homolateral axillary lymph nodes, but their ADC value were positively correlated. Therefore, the lymph nodes metastatic was correlated with the pathological grade, other than the TIC of the mass. Conclusion Preoperative MRI can effectively diagnose the metastasis of axillary lymph node in breast cancer patients.%目的 探讨术前MRI对乳腺癌腋窝淋巴结转移的诊断价值.方法 回顾性分析本院经手术病理证实的52例乳腺癌患者乳腺肿块同侧腋窝淋巴结的MR特征,探讨转移与非转移淋巴结的差异.结果 转移淋巴结数目增多,长径、短径、最大截面积均增大,与非转移淋巴结有显著差异(P<0.05),但其长短径比、表观扩散系数(Apparent Diffusion Coefficient, ADC)值、动态增强时间信号曲线TIC类型、最大信号强度、最大强化速率和最大强化率均无显著性差异(P>0.05).转移组乳腺原发肿块的最大径更大、ADC值更低,与非转移组有显著差异(P<0.05),但肿块的动态增强曲线类型、最大信号强度和最大强化率均无显著性差异(P>0.05).转移组乳腺肿块与同侧腋窝转移淋巴结的TIC曲线类型、最大信号强度无显著相关性,但其ADC值呈正相关.淋巴结转移与否与乳腺肿块的TIC曲线类型无关,而与其病理分级有关.结论 术前MRI能够有效的诊断乳腺癌腋窝淋巴结转移.

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