DWI最小表观扩散系数诊断乳腺导管内癌和浸润性癌的价值

摘要

Objective To explore the value of the minimum apparent diffusion coefficient (ADC-min) value in the diagnosis of ductal carcinoma in situ (DCIS) and invasive cancer of breast.Methods One hundred and forty nine cases of breast cancer verified by histopathology were included in this retrospective study.All the patients underwent dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) before the biopsy.The ADC min value and its correlation with invasive ductal carcinoma(IDC),DCIS and IDC-DCIS were analyzed.Results The mean ADC-min values for IDC,IDC-DCIS and DCIS were (0.95±0.16)×10-3 mm2/s,(1.07±0.13)×10-3 mm2/s and (1.24±0.18)×10-3 mm2/s,respectively.The ADC-min value of the three groups showed an increasing trend and there were significant differences (F=32.08,P＜0.01).The optimal cutoff ADC-min value was 1.02 × 10-3 mm2/s to differentiate DCIS from invasive cancer with a sensitivity of 95.0％ and a specificity of 63.6％.Conclusion The ADC min values are significantly different among IDC,IDC-DCIS and DCIS.It may be used as a reliable tool to differentiate DCIS and invasive cancer of breast.%目的 探讨最小表观扩散系数(ADC min)值在乳腺导管内癌(DCIS)和浸润性癌诊断中的价值.方法 回顾性分析经病理证实的乳腺癌病例149例,所有患者活检前行动态增强磁共振成像(DCE-MRI)和扩散加权成像(DWI).分析ADC-min值与乳腺浸润性导管癌(IDC)、DCIS、IDC合并DCIS(IDC-DCIS)的关系.结果 IDC、IDC-DCIS及DCIS的ADC-min均值分别为(0.95±0.16)×10-3mm2/s,(1.07±0.13)×10-3mm2/s,(1.24±0.18)×10-3 mm2/s,三者的ADC-min值呈升高的趋势,且有显著性差异(F=32.08,P＜0.01).ADC min值取1.02×10-3 mm2/s时是鉴别DCIS和浸润性癌的最佳阈值,此时诊断的敏感性和特异性分别为95.0％和63.6％.结论 乳腺IDC、IDC-DCIS及DCIS的ADC-min值有显著性差异.ADC-min值可作为鉴别乳腺DCIS和浸润性癌的一种有效工具.