王明甫;徐玮;秦涛;

• 1:湖北省第三人民医院放射科

摘要(Abstract)：

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。

关键词(KeyWords)： 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

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王明甫;徐玮;秦涛;

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参考文献(References)：

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