Yamaguchi Ken, Hara Yukiko, Kitano Isao, Hamamoto Takahiro, Kiyomatsu Kazumitsu, Yamasaki Fumio, Egashira Ryoko, Nakazono Takahiko, Irie Hiroyuki
1 Department of Radiology, Faculty of Medicine, Saga University , Saga , Japan.
2 Department of Radiology, Saga Central Hospital , Saga , Japan.
Br J Radiol. 2019 May;92(1097):20181032. doi: 10.1259/bjr.20181032. Epub 2019 Mar 15.
To correlate the tumor-stromal ratio (TSR) of invasive breast cancer and MRI findings.
This study was approved by our institutional review board. 126 consecutive patients with surgically proven invasive breast cancer were included. All patients underwent MRI exams including short-tau inversion-recovery (STIR) weighted imaging, diffusion-weighted imaging (DWI) and post-contrast dynamic imaging. The mean signal intensity (SI) and apparent diffusion coefficient (ADC) value of each lesion were measured. To objectively evaluate the STIR images, the ratio of the SI of the lesion to the muscle (L/M ratio) was also measured. Percentages of MRI kinetic parameters obtained from dynamic images were also measured. The TSR was defined as the percentage of the stromal component, and categorized into high-stroma ( 50%) and low-stroma (< 50%) groups. Intergroup differences in the SI, L/M ratio, ADC value and percentages of kinetic parameters were examined.
The SI and L/M ratio of the high-stroma group were significantly lower than those of the low-stromal group (208.64 331.86 for SI, 5.69 9.31 for L/M ratio) ( < 0.001). The high-stroma group had significantly lower percentages of a washout pattern (25% 34.7 %) ( = 0.012) and significantly higher percentages of a persistent pattern (36.92% 28.26 %) ( = 0.044). There were no significant correlations between the TSR and ADC value.
STIR and dynamic sequence of breast MRI reflects the stromal component of invasive breast cancer.
This is the first study to correlate TSR and MRI findings. STIR and post-contrast dynamic study correlated with the stromal component of breast cancer.
探讨浸润性乳腺癌的肿瘤-间质比（TSR）与MRI表现之间的相关性。
本研究经机构审查委员会批准。纳入126例经手术证实的浸润性乳腺癌患者。所有患者均接受了MRI检查，包括短反转恢复（STIR）加权成像、扩散加权成像（DWI）和对比剂增强动态成像。测量每个病灶的平均信号强度（SI）和表观扩散系数（ADC）值。为客观评估STIR图像，还测量了病灶与肌肉的信号强度比（L/M比）。同时测量动态图像获得的MRI动力学参数百分比。TSR定义为间质成分的百分比，并分为高间质（≥50%）和低间质（<50%）组。比较两组间SI、L/M比、ADC值和动力学参数百分比的差异。
高间质组的SI和L/M比显著低于低间质组（SI为208.64±331.86，L/M比为5.69±9.31）（P<0.001）。高间质组的廓清型百分比显著较低（25%±34.7%）（P=0.012），持续型百分比显著较高（36.92%±28.26%）（P=0.044）。TSR与ADC值之间无显著相关性。
乳腺MRI的STIR序列和动态序列反映了浸润性乳腺癌的间质成分。
这是第一项将TSR与MRI表现相关联的研究。STIR序列和对比剂增强动态研究与乳腺癌的间质成分相关。
