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动态对比增强磁共振成像和扩散加权成像作为淋巴结阴性浸润性乳腺癌中淋巴管浸润的预测指标

Dynamic contrast enhanced-MRI and diffusion-weighted image as predictors of lymphovascular invasion in node-negative invasive breast cancer.

作者信息

Choi Bo Bae

机构信息

Department of Radiology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.

出版信息

World J Surg Oncol. 2021 Mar 15;19(1):76. doi: 10.1186/s12957-021-02189-3.

Abstract

BACKGROUND

Lymphovascular invasion (LVI) is an important risk factor for prognosis of breast cancer and an unfavorable prognostic factor in node-negative invasive breast cancer patients. The purpose of this study was to evaluate the association between LVI and pre-operative features of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in node-negative invasive breast cancer.

METHODS

Data were collected retrospectively from 132 cases who had undergone pre-operative MRI and had invasive breast carcinoma confirmed on the last surgical pathology report. MRI and DWI data were analyzed for the size of tumor, mass shape, margin, internal enhancement pattern, kinetic enhancement curve, high intratumoral T2-weighted signal intensity, peritumoral edema, DWI rim sign, and apparent diffusion coefficient (ADC) values. We calculated the relationship between presence of LVI and various prognostic factors and MRI features.

RESULTS

Pathologic tumor size, mass margin, internal enhancement pattern, kinetic enhancement curve, DWI rim sign, and the difference between maximum and minimum ADC were significantly correlated with LVI (p < 0.05).

CONCLUSIONS

We suggest that DCE-MRI with DWI would assist in predicting LVI status in node-negative invasive breast cancer patients.

摘要

背景

淋巴管浸润(LVI)是乳腺癌预后的重要危险因素,也是腋窝淋巴结阴性的浸润性乳腺癌患者预后不良的因素。本研究旨在评估LVI与腋窝淋巴结阴性的浸润性乳腺癌患者术前动态对比增强磁共振成像(DCE-MRI)和扩散加权成像(DWI)特征之间的关联。

方法

回顾性收集132例术前行MRI检查且最后手术病理报告确诊为浸润性乳腺癌患者的数据。分析MRI和DWI数据,包括肿瘤大小、肿块形态、边缘、内部强化方式、强化动力学曲线、肿瘤内高T2加权信号强度、瘤周水肿、DWI边缘征及表观扩散系数(ADC)值。我们计算了LVI的存在与各种预后因素和MRI特征之间的关系。

结果

病理肿瘤大小、肿块边缘、内部强化方式、强化动力学曲线、DWI边缘征以及最大和最小ADC之间的差异与LVI显著相关(p<0.05)。

结论

我们认为,DCE-MRI联合DWI有助于预测腋窝淋巴结阴性的浸润性乳腺癌患者的LVI状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2983/7962354/0a3f52ba5910/12957_2021_2189_Fig1_HTML.jpg

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