乳腺疾病纤维化改变的乳腺超声弹性成像与磁共振成像：弹性成像结果与病理及短反转时间反转恢复成像结果之间的相关性，包括增强率和表观扩散系数。

Breast ultrasound elastography and magnetic resonance imaging of fibrotic changes of breast disease: correlations between elastography findings and pathologic and short Tau inversion recovery imaging results, including the enhancement ratio and apparent diffusion coefficient.

作者信息

Matsubayashi Roka Namoto, Imanishi Mika, Nakagawa Shino, Takahashi Ryuji, Akashi Momoko, Momosaki Seiya, Muranaka Toru

机构信息

From the *Breast Care Center, and †Clinical Research Institute, National Kyushu Medical Center; ‡Department of Radiology, National Hospital Organization Kumamoto Medical Center; and Departments of §Surgery, ∥Pathology, and ¶Radiology, National Kyushu Medical Center, Fukuoka, Japan.

出版信息

J Comput Assist Tomogr. 2015 Jan-Feb;39(1):94-101. doi: 10.1097/RCT.0000000000000155.

DOI:10.1097/RCT.0000000000000155

PMID:25299798

Abstract

PURPOSE

Ultrasound (US) elastography provides information regarding tissue hardness and is expected to become a novel diagnostic tool for breast disease. In contrast, magnetic resonance (MR) images reflect the tissue characteristics. Fibrosis of the stroma of breast diseases may affect their hardness. We investigated the correlation among elasticity score (ES) and signal intensity of short Tau inversion recovery MR images, enhancement ratio, apparent diffusion coefficient (ADC), and the fibrosis in the breast lesions.

MATERIALS AND METHODS

We reviewed the findings of US elastography and MR imaging from 41 consecutive patients with breast lesions (25 invasive ductal carcinoma, 3 fibroadenoma, 1 phyllodes tumor, 2 ductal hyperplasia, 2 primary malignant lymphoma, 3 mastopathy, 1 metastasis, 1 tubular adenoma, 1 ductal carcinoma in situ, 1 diabetic mastopathy, and 1 intraductal papilloma). In each patient, elastography images were classified based on Tsukuba ES. We calculated the ratio of signal intensity of the lesion to the muscle on short Tau inversion recovery images (L/M ratio), enhancement ratio of early to precontrast and early to delayed images, and ADC for each lesion. The ES and MR findings were correlated with the degree of fibrosis (based on Masson trichrome stain).

RESULTS

The ES significantly correlated with the L/M ratio (P = 0.0306) and the ADC (P = 0.0256). The stromal fibrosis also correlated with ES (P = 0.0023), the L/M ratio (P = 0.0344), and enhancement ratio of the early-to-delayed images (P = 0.049).

CONCLUSIONS

The ES and L/M ratio are correlated significantly with each other, and they are correlated with the fibrosis. These results suggest that they will provide the information on the fibrosis and may help the diagnosis of breast lesions.

摘要

目的

超声（US）弹性成像可提供有关组织硬度的信息，有望成为乳腺疾病的一种新型诊断工具。相比之下，磁共振（MR）图像反映组织特征。乳腺疾病间质纤维化可能会影响其硬度。我们研究了弹性评分（ES）与短Tau反转恢复MR图像信号强度、增强率、表观扩散系数（ADC）以及乳腺病变纤维化之间的相关性。

材料与方法

我们回顾了41例连续乳腺病变患者的超声弹性成像和MR成像结果（25例浸润性导管癌、3例纤维腺瘤、1例叶状肿瘤、2例导管增生、2例原发性恶性淋巴瘤、3例乳腺病、1例转移瘤、1例管状腺瘤、1例导管原位癌、1例糖尿病性乳腺病和1例导管内乳头状瘤）。在每位患者中，根据筑波弹性评分对弹性成像图像进行分类。我们计算了短Tau反转恢复图像上病变与肌肉的信号强度比（L/M比）、早期与对比前以及早期与延迟图像的增强率，以及每个病变的ADC。将弹性评分和MR表现与纤维化程度（基于Masson三色染色）进行相关性分析。