【摘要】 目的:探讨磁共振扩散成像ADC和eADC瘤周比评价乳腺癌对周围腺体的浸润。方法:回顾性分析我院病理诊断为乳腺浸润性导管癌Ⅱ级，单发肿块型，均行MR-DCE及DWI扫描的43个病例。在肿块前后、上下及内外侧缘方向每0.3cm测量瘤周腺体的ADC_3p～21p和eADC_3p～21p值，以强化瘤体、正常腺体及皮下脂肪为对照。计算瘤周腺体与强化瘤体、与正常腺体、与皮下脂肪r.ADC_{p/（m、n、f）}和r.eADC_{p/（m、n、f）}比值。比较各方向ADC和eADC、r.ADC_{3p～21p/（m、n、f）}和r.eADC_{3p～21p/（m、n、f）}的差别。结果:瘤周腺体与强化瘤体、正常腺体及皮下脂肪ADC和eADC比较、3p～21p各方向r.ADC_{p/（m、n、f）},r.eADC_{p/（m、n、f）}与相应对照差异比较均有统计学意义（P<0.01）。前缘3p～9p之间瘤周腺体eADCp、r.ADC_p/m、r.eADC_{p/（m、f）},3p～15p之间瘤周腺体r.eADC_p/n比较差异有统计学意义（P<0.01）。上缘3p～12p之间瘤周腺体r.ADC_{p/（m、f）}、r.eADC_p/m,3p～9p之间瘤周腺体r.eADC_{p/（n、f）}比较差异有统计学意义（P<0.01）。下缘3p～9p之间瘤周腺体eADC_p,3p～12p之间瘤周腺体r.ADC_p/m、r.eADC_p/m,3p～15p之间瘤周腺体r. ADC_p/f、r. eADC_p/f,3p～18p之间瘤周腺体r.ADC_p/n比较差异有统计学意义（P<0.01）。外缘3p～9p之间瘤周腺体r.eADC_p/f差异有统计学意义（P<0.01）。结论:各方向不同距离瘤周腺体、强化瘤体、皮下脂肪ADC和eADC值及比值的差异，能为MRI评价乳腺癌对瘤周腺体浸润提供依据。更多还原

【Abstract】 Objective:To investigate the invasion of the peritumoral glands in breast cancer by peritumor to tumor apparent diffusion coefficient and exponential apparent diffusion coefficient ratios.Methods:A retrospective analysis of 43 cases who were pathologically diagnosed as grade II invasive ductal breast cancer with single mass and underwent MRI-DCE and DWI scans was performed in our hospital. ADC_3p～21p and eADC_3p～21p values of peritumoral glands were measured every 0.3 cm on the leading edge, posterior margin, upper and inferior margin, inner and outer edge, respectively. The enhancing masses, normal glands and subcutaneous fat were used as controls. The ratios of r.ADC_{p/（m、n、f）} and r.eADC_{p/（m、n、f）} between peritumoral glands and enhancing masses, normal glands, subcutaneous fat were calculated. The differences of ADC and eADC values, r.ADC_{3p～21p/（m、n、f）} and r.eADC_{3p～21p/（m、n、f）} ratios were compared.Results:There were significant differences in ADC and eADC between peritumoral glands and enhancing masses, normal glands, and subcutaneous fat at each directions（P<0.01）.There were significant differences in r.ADC_{p/（m、n、f）}, r.eADC_{p/（m、n、f）} in all directions of 3p～21p compared with the corresponding controls（P<0.01）. There were significant differences in eADC_p and r.ADC_p/m,r.eADC_{p/（m、f）} among 3p～9p, in r.eADC_p/n among 3p～15p peritumoral glands on the leading edge（P<0.01）. There were significant differences in r. ADC_{p/（m、f）} and r.eADC_p/m among 3p～12p, in r.eADC_{p/（n、f）} among 3p～9p peritumoral glands on the upper margin（P<0.01）. There was significant differences in eADC_p among 3p～9p, in r.ADC_p/m and r.eADC_p/m among 3p～12p, in r.ADC_p/f and r.eADC_p/f among 3p～15p, in r.ADC_p/n among 3p～18p peritumoral glands on the inferior margin（P<0.01）. There was significant difference in r.eADC_p/f among 3p～9p peritumoral glands on the outer edge（P<0.01）.Conclusion:The differences in the values and ratios of ADC and eADC of the peritumoral glands, the enhanced masses, and the subcutaneous fat in different distances from each direction can provide the evidence for MRI evaluation of peritumoral gland invasion by breast cancer.更多还原