Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon.
Department of Gynecology and Obstetrics, Hôtel-Dieu de France University Hospital, Achrafieh, Lebanon.
Breast J. 2020 Nov;26(11):2177-2182. doi: 10.1111/tbj.14089. Epub 2020 Oct 18.
To evaluate the diagnostic value of diffusion-weighted imaging (DWI) in combination with conventional MRI in predicting metastatic axillary lymph nodes (ALN) in breast cancer (BC). We reviewed pathological findings and clinical breast MRI examinations of 169 patients with invasive BC who were evaluated at the Hôtel-Dieu de France Hospital in 2009-2015. Morphological parameters and apparent diffusion coefficient (ADC) value were compared with pathological nodal status. Independent t-test/chi-square test and a Pearson correlation analysis were used. With pathological diagnosis as reference, MRI-based interpretations were 87.5% specific and 70.3% sensitive. On conventional MRI, the round shape of lymph nodes (LNs), loss of fatty hilum, irregular margins and hypo-intensity/heterogeneous intensity on T2-weighted sequence were statistically significantly different between metastatic and nonmetastatic groups (P < .001, each). Mean size of metastatic ALN was larger compared with negative ALN (13.9 mm vs. 10.9 mm, P < .001). LNs ≥ 12 mm were associated with higher risk of metastasis (P < .001). ADC value was not significantly different between both groups (P = .862). Conventional MRI using the ALN shape, signal intensity in T2-weighted sequences, loss of fatty hilum, regularity of the margins and size of the LNs can evaluate the axilla with high specificity. ADC value could not be used as a reliable parameter.
评估弥散加权成像（DWI）联合常规 MRI 对乳腺癌（BC）腋窝转移性淋巴结（ALN）的诊断价值。我们回顾性分析了 2009 年至 2015 年在法国 Hôtel-Dieu 医院就诊的 169 例浸润性 BC 患者的病理发现和临床乳腺 MRI 检查结果。比较了形态学参数和表观扩散系数（ADC）值与病理淋巴结状态的关系。采用独立 t 检验/卡方检验和 Pearson 相关分析。以病理诊断为参考，MRI 解读的特异性为 87.5%，敏感性为 70.3%。在常规 MRI 上，淋巴结（LNs）的圆形形态、脂肪门消失、边缘不规则和 T2 加权序列上的低信号/不均匀信号在转移性和非转移性组之间有统计学差异（P<0.001，各）。与阴性 ALN 相比，转移性 ALN 的平均大小更大（13.9mm 比 10.9mm，P<0.001）。LN≥12mm 与转移风险增加相关（P<0.001）。两组间 ADC 值无显著差异（P=0.862）。使用 ALN 形状、T2 加权序列信号强度、脂肪门消失、边缘规则性和 LNs 大小的常规 MRI 可以高度特异性评估腋窝。ADC 值不能作为可靠的参数。
