摘要
目的探讨应用3.0 T磁共振动态增强(MRI-DCE)及扩散加权成像(DWI)诊断浸润性乳腺癌腋窝淋巴结(ALN)转移的价值。方法我院收治的143例早期浸润性乳腺癌患者,均接受MRI-DCE及DWI评估ALN转移情况,分析两者在ALN转移中诊断价值。结果以病理诊断为金标准,MRI-DCE联合DWI诊断ALN灵敏度、特异度、阳性预测值与阴性预测值分别为94.59%、96.23%、89.74%与98.08%;ALN转移与无ALN转移患者边界、早期强化模式、DWI信号、长径、短径、早期强化率、最大强化率、皮质厚度、表观扩散系数(ADC)值等MRI表现比较,差异有统计学意义(P<0.05);DWI高信号、短径及ADC值是ALN转移的影响因素(P<0.05);DWI信号、短径及ADC值诊断ALN转移曲线下面积(AUC)为0.619、0.745、0.734,各指标联合诊断ALN转移AUC值为0.835。结论3.0 T MR动态增强及扩散加权成像可以有效检出早期浸润性乳腺癌ALN转移,测定DWI信号、短径及ADC值联合有助于提高患者ALN转移诊断价值。
Objective To explore the value of 3.0 T magnetic resonance imaging dynamic contrast-enhanced(MRI-DCE)and diffusion-weighted imaging(DWI)in the diagnosis of axillary lymph node(ALN)metastasis of early invasive breast cancer.Methods One hundred and forty-three patients with early invasive breast cancer admitted to our hospital underwent the examinations of MRI-DCE and DWI to assess the condition of ALN metastasis.The diagnostic value of the two in ALN metastasis was analyzed.Results Pathological diagnosis was taken as the golden standard.The sensitivity of MRI-DCE combined with DWI in the diagnose ALN metastasis was 94.59%,the specificity was 96.23%,the positive predictive value was 89.74%and the negative predictive value was 98.08%.There were statistically significant differences in MRI findings such as boundary,early enhancement mode,DWI signal,long diameter,short diameter,early enhancement rate,maximum enhancement rate,cortical thickness,and apparent diffusion coefficient(ADC)between patients with and without ALN metastasis(P<0.05).High signal on DWI,short diameter and ADC value were important influencing factors of ALN metastasis(P<0.05).The area under curve(AUC)of the three indicators in the diagnosis of ALN metastasis was 0.619,0.745,and 0.734,respectively.The AUC value of combined diagnosis with these indicator was 0.835.Conclusion 3.0 T MRI-DCE and DWI can effectively detect ALN metastasis of early invasive breast cancer.The combination of DWI signal,short diameter and ADC value can improve the diagnostic performance for patients with ALN metastasis.
作者
罗兆丽
杨春华
王芳芳
姚辉莉
刘跃娜
LUO Zhao-li;YANG Chun-hua;WANG Fang-fang;YAO Hui-li;LIU Yue-na(Magnetic Resonance Room, The Third Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China)
出处
《实用医院临床杂志》
2022年第4期173-177,共5页
Practical Journal of Clinical Medicine
关键词
3.0
T磁共振
动态增强扫描
扩散加权成像
浸润性乳腺癌
腋窝淋巴结转移
诊断价值
3.0 T magnetic resonance
Dynamic contrast-enhanced scan
Diffusion-weighted imaging
Invasive breast cancer
Axillary lymph node metastasis
Diagnostic value
