Woodhams Reiko, Kakita Satoko, Hata Hirofumi, Iwabuchi Keiichi, Umeoka Shigeaki, Mountford Carolyn E, Hatabu Hiroto
Department of Radiology, Kitasato University School of Medicine and Kitasato University Hospital, Sagamihara, Kanagawa, Japan.
AJR Am J Roentgenol. 2009 Jul;193(1):260-6. doi: 10.2214/AJR.08.1670.
OBJECTIVE: The purposes of this study were to compare the apparent diffusion coefficient (ADC) of mucinous carcinoma of the breast with that of other breast tumors and to analyze correlations between signal intensity on diffusion-weighted images and the histologic features of mucinous carcinoma. SUBJECTS AND METHODS: Two hundred seventy-six patients with 277 lesions, including 15 mucinous carcinomas (13 pure type, two mixed type), 204 other malignant tumors, and 58 benign lesions, were examined with 1.5-T MRI at b values of 0 and 1,500 s/mm(2). The correlations between cellularity and ADC, homogeneity of signal intensity on diffusion-weighted images, and histopathologic findings were analyzed. The difference was statistically significant (p < 0.05). RESULTS: The mean ADC of mucinous carcinoma (1.8 +/- 0.4 x 10(-3) mm(2)/s) was statistically higher than that of benign lesions (1.3+/- 0.3 x 10(-3) mm(2)/s) and other malignant tumors (0.9 +/- 0.2 x 10(-3) mm(2)/s) (p < 0.001). The ADC of pure type mucinous carcinoma (1.8 +/- 0.3 x 10(-3) mm(2)/s) was higher than that of mixed type mucinous carcinoma (1.2 +/- 0.2 x 10(-3) mm(2)/s) (p < 0.001) and other histologic types (p > 0.05). The correlation between mean cellularity and the ADC of mucinous carcinoma was significant (rho(s) = -0.754; p = 0.001). The homogeneity of signal intensity on diffusion-weighted images correlated with the homogeneity of histologic structures of mucinous carcinoma (p < 0.001; kappa = 0.826). CONCLUSION: Mucinous carcinoma can be clearly differentiated from other breast tumors on the basis of ADC. The low signal intensity of mucinous carcinoma on diffusion-weighted images appears to reflect the presence of mucin and low cellularity. High signal intensity on diffusion-weighted images may reflect the presence of fibrovascular bundles, increased cell density, or a combination of these features.
目的：本研究旨在比较乳腺黏液腺癌与其他乳腺肿瘤的表观扩散系数（ADC），并分析扩散加权图像上的信号强度与黏液腺癌组织学特征之间的相关性。 对象与方法：对276例患者的277个病灶进行检查，其中包括15例黏液腺癌（13例纯型，2例混合型）、204例其他恶性肿瘤和58例良性病变，采用1.5-T磁共振成像（MRI），b值分别为0和1500 s/mm²。分析细胞密度与ADC、扩散加权图像上信号强度的均匀性以及组织病理学结果之间的相关性。差异具有统计学意义（p < 0.05）。 结果：黏液腺癌的平均ADC（1.8±0.4×10⁻³ mm²/s）在统计学上高于良性病变（1.3±0.3×10⁻³ mm²/s）和其他恶性肿瘤（0.9±0.2×10⁻³ mm²/s）（p < 0.001）。纯型黏液腺癌的ADC（1.8±0.3×10⁻³ mm²/s）高于混合型黏液腺癌（1.2±0.2×10⁻³ mm²/s）（p < 0.001）以及其他组织学类型（p > 0.05）。黏液腺癌的平均细胞密度与ADC之间存在显著相关性（rho(s)= -0.754；p = 0.001）。扩散加权图像上信号强度的均匀性与黏液腺癌组织结构的均匀性相关（p < 0.001；kappa = 0.826）。 结论：基于ADC可将黏液腺癌与其他乳腺肿瘤清楚地区分开来。黏液腺癌在扩散加权图像上的低信号强度似乎反映了黏液的存在和低细胞密度。扩散加权图像上的高信号强度可能反映了纤维血管束的存在、细胞密度增加或这些特征的组合。
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