【摘要】 目的分析3.0T磁共振扩散加权成像(diffusion weighted magnetic resonance imaging,DW-MRI)表观扩散系数(apparent diffusion coefficient,ADC)与乳腺浸润性导管癌(invasive ductal carcinoma,IDC)组织学分级的相关性。方法山东省肿瘤医院2012-06-01-2014-09-30经手术病理确诊的121例乳腺IDC患者,患者术前均行常规3.0T MRI和DW-MRI检查,分别测量不同分级乳腺癌病灶及对侧正常乳腺的ADC值进行比较。通过绘制ROC曲线,寻找鉴别IDC与对侧正常乳腺组织ADC值的最佳诊断界值。结果乳腺IDCⅠ级ADC值为(1.043±0.138)×10-3 mm2/s,Ⅱ级ADC值为(0.871±0.193)×10-3 mm2/s,Ⅲ级ADC值为(0.654±0.182)×10-3 mm2/s,两两比较各组间差异均有统计学意义,P值均<0.01;乳腺IDC ADC值与病理组织学分级呈负相关,r=-0.427,P<0.01。IDC ADC值为(0.864±0.205)×10-3 mm2/s,对侧正常乳腺组织ADC值为(1.653±0.328)×10-3 mm2/s,两者差异有统计学意义,P<0.01。鉴别IDC和对侧正常乳腺组织的最佳ADC值界值为1.192×10-3 mm2/s,诊断的敏感度和特异度分别为90.3%和92.6%,曲线下面积为0.931。结论 ADC值与乳腺IDC组织学分级存在一定相关性。更多还原

【Abstract】 OBJECTIVE To study the correlation between the diffusion weighted magnetic resonance imaging(DW-MRI)apparent diffusion coefficient(ADC)value and histological grade of breast invasive ductal carcinoma(IDC).METHODS This retrospective study included 121 patients with IDC verified by histology.Conventional MRI and DWMRI were performed using a 3.0T MR scanner with b value of 800s/mm2.ADC of the carcinoma and contralateral normal breast tissues were calculated.ROC analysis was used for distinguishing IDC and contralateral normal breast tissues.RESULTS The ADC value of gradeⅠ,gradeⅡ and gradeⅢlevel of IDC were(1.043±0.138)×10-3 mm2/s,(0.871±0.193)×10-3 mm2/s and(0.654±0.182)×10-3 mm2/s.Significant statistical difference was observed between gradeⅠ andⅡ,gradeⅡ andⅢ,gradeⅠ andⅢ.There was negative correlation between histological grade and ADC value.The ADC value of IDC and contralateral normal breast tissues were(0.864±0.205)×10-3 mm2/s and(1.653±0.328)×10-3 mm2/s.Significant statistical difference was observed between IDC and contralateral normal breast tissues.Thediagnostic cutoff value for IDC and contralateral normal breast tissues was 1.192×10-3 mm2/s.Corresponding sensitivity and specificity were 90.3% and 92.6%,respectively.The area under the ROC curve was 0.931.CONCLUSION ADC value of breast IDC is correlated with histological grade.更多还原