MRI对不同病理类型乳腺黏液腺癌的鉴别诊断

发布时间：2018-08-04 20:11

【摘要】：目的:探讨MRI平扫、扩散加权成像(DWI)、动态增强及表观扩散系数(ADC)值对单纯型与混合型乳腺黏液腺癌的鉴别诊断价值。方法:回顾性分析经手术病理证实的38例单纯型乳腺黏液腺癌与16例混合型乳腺黏液腺癌患者的MRI资料,观察比较两组不同病理类型的乳腺黏液腺癌的MRI表现特征。结果:(1)边缘:29例单纯型黏液腺癌边缘清晰(29/40),11例混合型黏液腺癌边缘不清晰(11/16);(2)TIC曲线:24例单纯型黏液腺癌延迟期TIC曲线呈上升型(24/40),11例混合型黏液腺癌TIC曲线呈平台型(11/16);(3)ADC值:单纯型黏液腺癌平均ADC值(1.62±0.47)×10~(-3) mm~2/s高于混合型黏液腺癌平均ADC值(1.23±0.32)×10~(-3) mm~2/s。ADC值ROC曲线下面积0.733,最佳临界值1.615×10~(-3) mm~2/s,诊断敏感度和特异度分别为57.7%、88.9%。单纯型和混合型黏液腺癌在肿块边缘、TIC曲线及ADC值等方面差异均有统计学意义(P0.05)。结论:不同病理类型的乳腺黏液腺癌MRI表现有所不同,MRI多种成像序列相结合在单纯型与混合型乳腺黏液腺癌术前诊断及鉴别诊断中具有重要价值。
[Abstract]:Objective: to evaluate the value of MRI plain scan, diffusion weighted (DWI), dynamic enhancement and apparent diffusion coefficient (ADC) in the differential diagnosis of simple and mixed breast mucinous adenocarcinoma. Methods: the MRI data of 38 cases of simple breast mucinous adenocarcinoma and 16 cases of mixed type breast mucinous adenocarcinoma proved by surgery and pathology were analyzed retrospectively. The MRI features of the two groups were compared. Results: (1) the margin of 29 cases of simple mucinous adenocarcinoma (29 / 40) and 11 cases of mixed mucinous adenocarcinoma (11 / 16); (_ 2) TIC curve were clear (11 / 16); (_ 2). 24 cases of simple mucinous adenocarcinoma showed ascending (24 / 40) TIC curve and 11 cases of mixed mucinous adenocarcinoma showed platform TIC curve. (11 / 16); (3) ADC value: the average ADC value of simple mucinous adenocarcinoma (1.62 卤0.47) 脳 10 ~ (-3) mm~2/s was higher than that of mixed mucinous adenocarcinoma (1.23 卤0.32) 脳 10 ~ (-3) mm~2/s.ADC ROC, the area under ROC curve was 0.733, the best critical value was 1.615 脳 10 ~ (-3) mm ~ (-2) s, the diagnostic sensitivity and specificity were 57.7 ~ (-3) mm ~ (-2) 路s, respectively. There were significant differences in TIC curve and ADC between simple and mixed mucinous adenocarcinoma (P0.05). Conclusion: the MRI findings of different pathological types of mucinous breast adenocarcinoma are different. The combination of multiple MRI sequences has important value in the preoperative diagnosis and differential diagnosis of simple and mixed breast mucinous adenocarcinoma.
【作者单位】：中国医科大学肿瘤医院/辽宁省肿瘤医院医学影像科;
【基金】：国家公益性行业科研专项(201402020)
【分类号】：R445.2;R737.9

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