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MRI检查结果提示浸润性乳腺癌患者存在腋窝转移性淋巴结。

MRI Findings Suggestive of Metastatic Axillary Lymph Nodes in Patients with Invasive Breast Cancer.

作者信息

Kim Ka Eun, Kim Shin Young, Ko Eun Young

出版信息

Taehan Yongsang Uihakhoe Chi. 2022 May;83(3):620-631. doi: 10.3348/jksr.2021.0097. Epub 2021 Dec 11.

DOI:10.3348/jksr.2021.0097
PMID:36238525
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9514532/
Abstract

PURPOSE

This study aimed to investigate the diagnostic performance of features suggestive of nodal metastasis on preoperative MRI in patients with invasive breast cancer.

MATERIALS AND METHODS

We retrospectively reviewed the preoperative breast MRI of 192 consecutive patients with surgically proven invasive breast cancer. We analyzed MRI findings of axillary lymph nodes with regard to the size, long/short ratio, cortical thickness, shape and margin of the cortex, loss of hilum, asymmetry, signal intensity (SI) on T2-weighted images (T2WI), degree of enhancement in the early phase, and enhancement kinetics. Receiver operating characteristic (ROC) analysis, chi-square test, test, and McNemar's test were used for statistical analysis.

RESULTS

Increased shorter diameter, uneven cortical shape, increased cortical thickness, loss of hilum, asymmetry, irregular cortical margin, and low SI on T2WI were significantly suggestive of metastasis. ROC analysis revealed the cutoff value for the shorter diameter and cortical thickness as 8.05 mm and 2.75 mm, respectively. Increased cortical thickness (> 2.75 mm) and uneven cortical shape showed significantly higher sensitivity than other findings in McNemar's test. Irregular cortical margins showed the highest specificity (100%).

CONCLUSION

Cortical thickness > 2.75 mm and uneven cortical shape are more sensitive parameters than other findings, and an irregular cortical margin is the most specific parameter for predicting axillary metastasis in patients with invasive breast cancer.

摘要

目的

本研究旨在探讨术前MRI上提示有淋巴结转移的特征对浸润性乳腺癌患者的诊断效能。

材料与方法

我们回顾性分析了192例经手术证实为浸润性乳腺癌患者的术前乳腺MRI。我们分析了腋窝淋巴结的MRI表现，包括大小、长短径比、皮质厚度、皮质形状和边缘、门部消失、不对称性、T2加权像（T2WI）上的信号强度（SI）、早期强化程度及强化动力学。采用受试者操作特征（ROC）分析、卡方检验、t检验和McNemar检验进行统计分析。

结果

短径增加、皮质形状不均匀、皮质厚度增加、门部消失、不对称性、皮质边缘不规则及T2WI上低SI均显著提示转移。ROC分析显示，短径和皮质厚度的截断值分别为8.05 mm和2.75 mm。在McNemar检验中，皮质厚度增加（>2.75 mm）和皮质形状不均匀的敏感性显著高于其他表现。皮质边缘不规则的特异性最高（100%）。

结论

皮质厚度>2.75 mm和皮质形状不均匀是比其他表现更敏感的参数，皮质边缘不规则是预测浸润性乳腺癌患者腋窝转移最具特异性的参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/b96c8c3f443f/jksr-83-620-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/c97e98d71cd7/jksr-83-620-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/36fd6fb5977a/jksr-83-620-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/b96c8c3f443f/jksr-83-620-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/c97e98d71cd7/jksr-83-620-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/36fd6fb5977a/jksr-83-620-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3885/9514532/b96c8c3f443f/jksr-83-620-g003.jpg

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Diffusion-weighted MR imaging increases diagnostic accuracy of breast MR imaging for predicting axillary metastases in breast cancer patients.弥散加权磁共振成像提高了乳腺癌患者腋窝转移的乳腺磁共振成像预测的诊断准确性。
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