【摘要】：目的探討動態(tài)增強掃描MR(DCE-MRI)及彌散加權MRI(DW-MRI)在乳腺癌術后隨訪中的應用價值。方法回顧性分析35例乳腺癌保乳術患者的MRI、臨床及病理資料。所有患者均行DCE-MRI及DW-MRI掃描,將MRI結果與病理資料行對照研究,比較分析乳腺癌術后瘢痕與腫瘤復發(fā)的DCE-MRI及DWMRI影像特點,獲取時間-信號強度曲線(TIC)、測量早期強化率(ECR);DW-MRI b值取0、1 000 s/mm2,測量病灶的表觀擴散系數(ADC)值。繪制ROC曲線評價以上參數的診斷價值。結果 TIC類型、ECR及ADC值在乳腺癌術后瘢痕與腫瘤復發(fā)之間差異有統(tǒng)計學意義(P0.05)。瘢痕組織的早期強化率均值小于復發(fā)病灶,ADC值均值大于復發(fā)病灶;復發(fā)病灶TIC類型多為Ⅲ型,瘢痕組織TIC類型多為Ⅰ型。繪制ROC曲線,ECR及ADC值的ROC曲線下面積分別為0.778及0.81。以ADC值=1.14×(10-3mm2/s)為臨界值,其鑒別診斷保乳術后瘢痕組織及復發(fā)病灶敏感度、特異度、準確率分別為85.6%、60.1%、75.1%。結論 ECR、TIC類型及ADC值均有助于乳腺保乳術后瘢痕組織及復發(fā)病灶的診斷和鑒別診斷,可作為乳腺癌保乳術患者隨訪的重要手段。
[Abstract]:Objective to evaluate the value of dynamic contrast-enhanced Mr (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in postoperative follow-up of breast cancer. Methods the MRI, clinical and pathological data of 35 breast cancer patients undergoing breast conserving surgery were analyzed retrospectively. All the patients underwent DCE-MRI and DW-MRI. The MRI results were compared with the pathological data, and the features of DCE-MRI and DWMRI in scar and tumor recurrence after breast cancer operation were compared and analyzed. The time-signal intensity curve (TIC) was obtained, and the early enhancement rate (ECR) and DW-MRI b were measured. The apparent diffusion coefficient (ADC) was measured. To evaluate the diagnostic value of the above parameters by drawing the ROC curve. Results the values of ECR and ADC in TIC type were significantly different between postoperative scar and recurrence of breast cancer (P0.05). The early enhancement rate of scar tissue was lower than that of recurrent lesion, and the TIC type of recurrent lesion was type 鈪，

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