磁共振扩散加权成像在乳腺良性与恶性病变中表观扩散系数值分布的特征比较研究简

目的：对乳腺良恶性病变及其周围腺体的磁共振扩散加权成像（DWI）中表观扩散系数（ADC）值分布特征进行分析。方法回顾性分析经病理证实的41个浸润性导管癌和23个纤维腺瘤的DWI图像，测量瘤区（G1）、近瘤区（G2）、远瘤区（G3）及对侧正常腺体区（G4）ADC值，比较不同区域的分布及差异。结果41个浸润性导管癌DWI为高信号，平均ADC值（1．13±0．16）×10-3 mm2/s，而23例纤维腺瘤DWI为等或略高信号为主，平均ADC值（1．69±0．18）×10-3 mm2/s，两者ADC值比较差异有统计学意义（t＝12．31，P＜0．05）。浸润性导管癌自G1区至G4区ADC值逐渐升高，其中G1与G4区、G2与G4区、G1与G2区ADC值比较差异有统计学意义（P＜0．05），G3与G4区的ADC值比较差异无统计学意义（P＞0．05）；纤维腺瘤各区与对侧正常腺体G4区之间及G1与G2区之间ADC值比较差异均无统计学意义（P＞0．05）。结论 ADC值在浸润性导管癌内部及周围区域的分布有一定的规律，通过对近瘤区ADC值测量，有助于判断乳腺癌是否周围浸润及为保乳手术提供依据。

Comparison of the distribution of apparent diffusion coefficient values in diffusion-weighted MR imaging of breast between benign and malignant lesions

Objective To investigate the distribution of apparent diffusion coefficient（ADC） values in diffusion-weighted MR imaging （DWI） of breast with benign and malignant lesions and peri-tumor regions. Methods DWI of 41 infiltrating duct carcinoma patients and 23 fibroadenoma patients confirmed histopathologically were analyzed ret-rospectively. The ADC values of 4 regions were measured, including： intra-tumor （G1）, peri-tumor （G2）, access-tumor （G3） and contralateral normal region （G4）. Then analyze the distribution and pattern of ADC values. Results Forty-one infiltrating duct carcinoma manifested high signal in DWI, with the mean ADC value was （1.13±0.16）×10-3 mm2/s. Twenty-three fibroadenoma manifested equal or slightly high signal in DWI, with the mean ADC was （1.69±0.18）×10-3 mm2/s. There was significant difference between those two groups （t=12.31, P〈0.05）. The ADC values gradually in-creased from G1 to G4 region in infiltrating duct carcinoma. There were significant differences of the ADC value be-tween region G1 and G4, G2 and G4, G1 and G2（P〈0.05）. But there was no significant difference of the ADC value between region G3 and G4 （P〉0.05）. There were no significant differences of the ADC value in fibroadenoma groups （P〉0.05）. Conclusion The distribution of the ADC values in infiltrating duct carcinoma have a certain regularity. The measurement of the ADC values in peri-tumor region is expected to help determine whether the breast cancer is infiltrative, providing the basis for the breast conserving surgery.