CAJ | 학술논문

目的：对乳腺良恶性病变及其周围腺体的磁共振扩散加权成像（DWI）中表观扩散系数（ADC）值分布特征进行分析。方法回顾性分析经病理证实的41个浸润性导管癌和23个纤维腺瘤的DWI图像，测量瘤区（G1）、近瘤区（G2）、远瘤区（G3）及对侧正常腺体区（G4）ADC值，比较不同区域的分布及差异。结果41个浸润性导管癌DWI为高信号，平均ADC值（1．13±0．16）×10-3 mm2/s，而23例纤维腺瘤DWI为等或略高信号为主，平均ADC值（1．69±0．18）×10-3 mm2/s，两者ADC值比较差异有统计学意义（t＝12．31，P＜0．05）。浸润性导管癌自G1区至G4区ADC值逐渐升高，其中G1与G4区、G2与G4区、G1与G2区ADC值比较差异有统计学意义（P＜0．05），G3与G4区的ADC值比较差异无统计学意义（P＞0．05）；纤维腺瘤各区与对侧正常腺体G4区之间及G1与G2区之间ADC值比较差异均无统计学意义（P＞0．05）。结论 ADC值在浸润性导管癌内部及周围区域的分布有一定的规律，通过对近瘤区ADC值测量，有助于判断乳腺癌是否周围浸润及为保乳手术提供依据。
목적：대유선량악성병변급기주위선체적자공진확산가권성상（DWI）중표관확산계수（ADC）치분포특정진행분석。방법회고성분석경병리증실적41개침윤성도관암화23개섬유선류적DWI도상，측량류구（G1）、근류구（G2）、원류구（G3）급대측정상선체구（G4）ADC치，비교불동구역적분포급차이。결과41개침윤성도관암DWI위고신호，평균ADC치（1．13±0．16）×10-3 mm2/s，이23례섬유선류DWI위등혹략고신호위주，평균ADC치（1．69±0．18）×10-3 mm2/s，량자ADC치비교차이유통계학의의（t＝12．31，P＜0．05）。침윤성도관암자G1구지G4구ADC치축점승고，기중G1여G4구、G2여G4구、G1여G2구ADC치비교차이유통계학의의（P＜0．05），G3여G4구적ADC치비교차이무통계학의의（P＞0．05）；섬유선류각구여대측정상선체G4구지간급G1여G2구지간ADC치비교차이균무통계학의의（P＞0．05）。결론 ADC치재침윤성도관암내부급주위구역적분포유일정적규률，통과대근류구ADC치측량，유조우판단유선암시부주위침윤급위보유수술제공의거。
Objective To investigate the distribution of apparent diffusion coefficient(ADC) values in diffusion-weighted MR imaging (DWI) of breast with benign and malignant lesions and peri-tumor regions. Methods DWI of 41 infiltrating duct carcinoma patients and 23 fibroadenoma patients confirmed histopathologically were analyzed ret-rospectively. The ADC values of 4 regions were measured, including: intra-tumor (G1), peri-tumor (G2), access-tumor (G3) and contralateral normal region (G4). Then analyze the distribution and pattern of ADC values. Results Forty-one infiltrating duct carcinoma manifested high signal in DWI, with the mean ADC value was (1.13±0.16)×10-3 mm2/s. Twenty-three fibroadenoma manifested equal or slightly high signal in DWI, with the mean ADC was (1.69±0.18)×10-3 mm2/s. There was significant difference between those two groups (t=12.31, P<0.05). The ADC values gradually in-creased from G1 to G4 region in infiltrating duct carcinoma. There were significant differences of the ADC value be-tween region G1 and G4, G2 and G4, G1 and G2(P<0.05). But there was no significant difference of the ADC value between region G3 and G4 (P>0.05). There were no significant differences of the ADC value in fibroadenoma groups (P>0.05). Conclusion The distribution of the ADC values in infiltrating duct carcinoma have a certain regularity. The measurement of the ADC values in peri-tumor region is expected to help determine whether the breast cancer is infiltrative, providing the basis for the breast conserving surgery.