Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A Gemelli, Lgo A Gemelli 8, 00168 Rome, Italy.
Eur J Radiol. 2010 Aug;75(2):e114-23. doi: 10.1016/j.ejrad.2010.01.018. Epub 2010 Feb 20.
Purpose of our study is to evaluate the role of the apparent diffusion coefficient (ADC) in the diagnosis of recurrent tumor on the scar in patients operated for breast cancer. Assess, therefore, the weight of diagnostic diffusion echo-planar sequence, in association with the morphological and dynamic sequences in the diagnosis of tumor recurrence versus surgical scar.
From September 2007 to March 2009, 72 patients operated for breast cancer with suspected recurrence on the scar were consecutively subjected to magnetic resonance imaging (MRI), including use of a diffusion sequence. All patients with pathological enhancement in the scar were then subjected to histological typing. MRI was considered negative in the absence of areas of suspicious enhancement. In all cases it was measured the ADC value in the scar area or in the area with pathological enhancement. The ADC values were compared with MRI findings and histological results obtained.
26 cases were positive/doubtful at MRI and then subjected to histological typing: of these recurrences were 20 and benign were 6. 46 cases were judged negative at MRI and therefore not sent to cyto-histology. The average ADC value of recurrences was statistically lower of scarring (p<0.001).
ADC value can be a specific parameter in differential diagnosis between recurrence and scar. The diffusion sequence, in association with the morphological and dynamic sequences, can be considered a promising tool for the surgical indication in suspected recurrence of breast cancer.
本研究旨在评估表观扩散系数（ADC）在诊断乳腺癌手术后瘢痕中复发性肿瘤的作用。因此，评估诊断性弥散回波平面序列的权重，以及在诊断肿瘤复发与手术瘢痕方面的形态学和动态序列的权重。
从 2007 年 9 月至 2009 年 3 月，72 例乳腺癌术后怀疑瘢痕处复发的患者连续接受磁共振成像（MRI）检查，包括使用弥散序列。所有瘢痕处有病理增强的患者随后进行组织学分型。如果瘢痕处无可疑增强区，则 MRI 被认为是阴性的。在所有病例中，均在瘢痕区或病理增强区测量 ADC 值。将 ADC 值与 MRI 发现和获得的组织学结果进行比较。
26 例 MRI 阳性/可疑，然后进行组织学分型：其中复发 20 例，良性 6 例。46 例 MRI 判为阴性，因此未进行细胞病理学检查。复发的平均 ADC 值明显低于瘢痕（p<0.001）。
ADC 值可以作为复发性与瘢痕之间鉴别诊断的一个特异性参数。弥散序列与形态学和动态序列联合使用，可以被认为是对乳腺癌可疑复发患者手术适应证的一种有前途的工具。
