摘要
目的探讨扩散加权成像(diffusion weighted imaging,DWI)定量参数及动态对比增强(dynamic contrast-enhanced,DCE)半定量参数对乳腺良恶性肿瘤的鉴别诊断及其与乳腺癌生物学指标的相关性。材料与方法回顾性分析本院50例乳腺肿瘤患者临床病例资料,根据手术切除后病理结果分为乳腺癌组(31例)及良性肿瘤组(19例),并对所有乳腺癌患者进行免疫组化检查,进一步分为孕激素受体(progesterone receptor,PR)、雌激素受体(estrogenreceptor,ER)、人类上皮因子受体-2(humanepithelialfactor receptor-2,HER-2)阳性组及PR、ER、HER-2阴性组。所有患者均行DWI及DCE检查,对DWI定量参数ADC及DCE半定量参数峰值时间(peak time,Tmax)、早期强化率(early enhancementrate,EER)、峰值强化率(peakenhancementrate,Emax)进行测量。采用免疫组化法检测细胞增殖抗原标记物Ki-67、PR、ER及HER-2等乳腺癌生物学指标。比较乳腺肿瘤良恶性组MR定量参数及半定量参数的差异,并分析各参数与乳腺癌生物学指标的相关性。结果乳腺癌组EER高于良性肿瘤组(P<0.05),而ADC、Tmax、Emax值均低于良性肿瘤组(P均<0.05)。乳腺癌PR、ER、HER-2阳性组的ADC值与阴性组比较无差异(P>0.05);乳腺癌PR、ER、HER-2阳性组的Tmax、Emax值均低于阴性组(P均<0.05);PR、ER、HER-2阳性组EER明显高于阴性组(P<0.05)。EER与Ki-67的表达呈正相关(r=0.49,P<0.01);ADC、Tmax、Emax值与Ki-67的表达均呈负相关(r=-0.52、-0.45、-0.43,P均<0.05)。结论 DWI定量参数及DCE半定量参数不仅可用于乳腺良、恶性肿瘤的鉴别诊断,也可作为乳腺癌生物学行为的预测指标,为临床医师治疗提供一定信息。
Objective:To investigate the differential diagnosis of MRI diffusion weighted imaging(DWI)and semi-quantitative dynamic contrast-enhanced(DCE)parameters for benign and malignant breast tumors and their correlation with the biological parameters of breast cancer.Materials and Methods:The clinical datas of 50 patients with breast tumor in our hospital were retrospectively analyzed.According to the pathological results after surgical resection,they were divided into the breast cancer group(31 cases)and the benign tumor group(19 cases).Immunohistochemical examination was performed on all the breast cancer patients,and they were further divided into the PR,ER and HER-2 positive groups and the progesterone receptor(PR),estrogen receptor(ER)and human epithelial factor receptor-2(HER-2)negative groups.All patients were examined by DWI and DCE.The apparent diffusion coefficient(ADC)and the peak time(Tmax),the early enhancement rate(EER)and the peak enhancement rate(Emax)of DCE were measured.Immunohistochemistry was used to detect the biological indicators of breast cancer,such as cell proliferation antigen markers Ki-67,PR,ER and HER-2.The differences of MR quantitative parameters and semi-quantitative parameters in benign and malignant breast tumors were compared,and the correlation between these parameters and biological indicators of breast cancer was analyzed.Results:The EER in the breast cancer group was higher than that in the benign tumor group(P<0.05),while ADC,Tmax and Emax values were all lower than that in the benign tumor group(P<0.05).There was no difference in ADC values between the positive group and the negative group(P>0.05).The Tmax and Emax values of the positive breast cancer PR,ER and HER-2 groups were all lower than those of the negative group(P values were all less than 0.05).EER wassignificantly higher in the positive group of PR,ER and HER-2 than in the negative group(P<0.05).EER was positively correlated with Ki-67 expression(r=0.49,P<0.01).ADC,Tmax and Emax values were negatively correlated with Ki-67 expression(r=-0.52,-0.45 and-0.43,all P values were less than 0.05).Conclusions:DWI quantitative parameters and DCE semi-quantitative parameters can not only be used in the differential diagnosis of benign and malignant breast tumors,but also can be used as the prediction index of biological behavior of breast cancer,which provide information for clinicians to treate.
作者
王明甫
徐玮
秦涛
WANG Mingfu;XU Wei;QIN Tao(Department of Radiology,the Third People’s Hospital of Hubei Province,Wuhan 430033,China)
出处
《磁共振成像》
CAS
2020年第12期1174-1177,共4页
Chinese Journal of Magnetic Resonance Imaging
关键词
磁共振成像
乳腺肿瘤
鉴别诊断
预后因子
扩散加权成像
动态对比增强
magnetic resonance imaging
breast tumor
differential diagnosis
prognostic factor
diffusion weighted imaging
dynamic contrast-enhanced
作者简介
通信作者:秦涛,E-mail:qyypiano@163.com。
