动态增强扫描MR及弥散加权MRI在监测乳腺癌保乳术后肿瘤复发中的价值

发布时间：2018-07-18 12:49

【摘要】：目的探讨动态增强扫描MR(DCE-MRI)及弥散加权MRI(DW-MRI)在乳腺癌术后随访中的应用价值。方法回顾性分析35例乳腺癌保乳术患者的MRI、临床及病理资料。所有患者均行DCE-MRI及DW-MRI扫描,将MRI结果与病理资料行对照研究,比较分析乳腺癌术后瘢痕与肿瘤复发的DCE-MRI及DWMRI影像特点,获取时间-信号强度曲线(TIC)、测量早期强化率(ECR);DW-MRI b值取0、1 000 s/mm2,测量病灶的表观扩散系数(ADC)值。绘制ROC曲线评价以上参数的诊断价值。结果 TIC类型、ECR及ADC值在乳腺癌术后瘢痕与肿瘤复发之间差异有统计学意义(P0.05)。瘢痕组织的早期强化率均值小于复发病灶,ADC值均值大于复发病灶;复发病灶TIC类型多为Ⅲ型,瘢痕组织TIC类型多为Ⅰ型。绘制ROC曲线,ECR及ADC值的ROC曲线下面积分别为0.778及0.81。以ADC值=1.14×(10-3mm2/s)为临界值,其鉴别诊断保乳术后瘢痕组织及复发病灶敏感度、特异度、准确率分别为85.6%、60.1%、75.1%。结论 ECR、TIC类型及ADC值均有助于乳腺保乳术后瘢痕组织及复发病灶的诊断和鉴别诊断,可作为乳腺癌保乳术患者随访的重要手段。
[Abstract]:Objective to evaluate the value of dynamic contrast-enhanced Mr (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in postoperative follow-up of breast cancer. Methods the MRI, clinical and pathological data of 35 breast cancer patients undergoing breast conserving surgery were analyzed retrospectively. All the patients underwent DCE-MRI and DW-MRI. The MRI results were compared with the pathological data, and the features of DCE-MRI and DWMRI in scar and tumor recurrence after breast cancer operation were compared and analyzed. The time-signal intensity curve (TIC) was obtained, and the early enhancement rate (ECR) and DW-MRI b were measured. The apparent diffusion coefficient (ADC) was measured. To evaluate the diagnostic value of the above parameters by drawing the ROC curve. Results the values of ECR and ADC in TIC type were significantly different between postoperative scar and recurrence of breast cancer (P0.05). The early enhancement rate of scar tissue was lower than that of recurrent lesion, and the TIC type of recurrent lesion was type 鈪，

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