CAJ | 학술논문

目的：研究磁共振动态增强及扩散加权成像上乳腺癌癌周间质的影像学表现，并探讨其对确定乳腺癌肿瘤边界的价值。方法：搜集2012年10月-2014年3月行乳腺 MRI 检查，手术或穿刺活检病理证实为乳腺癌的患者共31例（所选病例均为单侧单中心发病）。测量乳腺癌病灶与病灶周围组织不同方向上的表观扩散系数（ADC）值及信号增强率（SER），并进行统计学分析。结果：横轴面 DWI 图像：乳腺癌病灶内的 ADC 值显著低于病灶周围组织；乳腺癌周围组织同一层面不同方向的 ADC 值之间差异无统计学意义（P ＞0．05）；但对于同一方向上的不同层面，靠近病灶的第1层（范围约5mm）的 ADC 值小于远离它的3个层面（P ＜0．05）；乳腺癌、癌旁组织、正常侧乳腺组织的平均 ADC 值之间差异具有统计学意义（F ＝32．496，P ＝0．000）。横轴面动态增强图像：乳腺癌病灶内的 SER 显著高于病灶周围组织；但病灶周围组织各层面之间 SER 的差别无统计学意义（P ＞0．05）；病灶周围组织同一层面的不同方向的 SER 之间差异无统计学意义（P ＞0．05）。结论：MR 动态增强的 SER 及 DWI 成像的 ADC 值对乳腺癌与癌周间质组织的判别有一定的敏感性和特异性，有望成为确定乳腺癌范围及手术切缘的有效影像学方法。
목적：연구자공진동태증강급확산가권성상상유선암암주간질적영상학표현，병탐토기대학정유선암종류변계적개치。방법：수집2012년10월-2014년3월행유선 MRI 검사，수술혹천자활검병리증실위유선암적환자공31례（소선병례균위단측단중심발병）。측량유선암병조여병조주위조직불동방향상적표관확산계수（ADC）치급신호증강솔（SER），병진행통계학분석。결과：횡축면 DWI 도상：유선암병조내적 ADC 치현저저우병조주위조직；유선암주위조직동일층면불동방향적 ADC 치지간차이무통계학의의（P ＞0．05）；단대우동일방향상적불동층면，고근병조적제1층（범위약5mm）적 ADC 치소우원리타적3개층면（P ＜0．05）；유선암、암방조직、정상측유선조직적평균 ADC 치지간차이구유통계학의의（F ＝32．496，P ＝0．000）。횡축면동태증강도상：유선암병조내적 SER 현저고우병조주위조직；단병조주위조직각층면지간 SER 적차별무통계학의의（P ＞0．05）；병조주위조직동일층면적불동방향적 SER 지간차이무통계학의의（P ＞0．05）。결론：MR 동태증강적 SER 급 DWI 성상적 ADC 치대유선암여암주간질조직적판별유일정적민감성화특이성，유망성위학정유선암범위급수술절연적유효영상학방법。
Objective:To evaluate tumor margin by dynamic contrast enhanced MRI and diffusion-weighted imaging in breast cancer.Methods:The study included 31 cases of breast cancer which were examined with dynamic contrast enhanced MRI and diffusion-weighted imaging (DWI)before operation in our hospital performed from June 2012 to March 2014.The ADC and signal enhancement ratio (SER)values of the tumor tissue and breast stroma beyond the tumor margin were measured and analyzed statistically.Results:The ADC value of breast cancer was significantly lower than that of the stroma beyond the tumor margin.There was no statistically different in ADC values among different directions (anterior,posterior, left and right)within the same slice (P >0.05).However,there was a statistically significant difference among the ADC values in the tissue of the first slice adjacent to tumor and in the tissues of other three slices away from tumor (P <0.05). The SER value in the tissue of breast cancer was significantly higher than that of the stroma beyond the tumor margin. There was no statistically significant difference in SER values among different directions (anterior,posterior,left and right) within the same slice (P >0.05).Conclusion:ADC and SER values were sensitive and specific parameters that could help differentiate malignant breast lesions and normal tissue.They could be regarded as promising methods for helping determine surgical scope and margin of breast carcinoma in the future.