文章摘要

IVIM-DWI参数在乳腺癌诊断中的应用及其与免疫组织化学指标表达的关系

作者: 1张娟, 1苗重昌, 1王德华, 1江顺斌, 1江科逸
1 徐州医科大学附属连云港医院影像科,江苏 连云港 222000
通讯: 苗重昌 Email: lygzhchmiao@163.com
DOI: 10.3978/j.issn.2095-6959.2022.04.017

摘要

目的:研究体素内不相干运动扩散加权成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)参数在乳腺癌诊断中的应用及其与免疫组织化学指标表达的关系。方法:回顾性分析2019年12月至2020年12月徐州医科大学附属连云港医院收治的70例疑似乳腺癌患者,采用Philips Ingenia 3.0 T超导型磁共振扫描仪和乳腺专用相控线圈进行检测,通过影像学序列设定,分别测定表观扩散系数(apparent diffusion coefficient,ADC)值、慢扩散系数(slow diffusion coefficient,D)值、快扩散系数(fast diffusion coefficient,D*)值、灌注分数(perfusion fraction,f)值,同时进行免疫生化指标雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)及细胞增殖抗原标志物Ki-67的测定。结果:病理检查诊断良性肿瘤22例,恶性肿瘤48例;ER阳性54例,阴性16例;PR阳性50例,阴性20例;Ki-67高表达55例,低表达15例;HER-2阳性27例,阴性43例。恶性肿瘤患者ADC值、D值、D*值低于良性肿瘤患者,f值高于恶性肿瘤患者,差异有统计学意义(P<0.05)。ER阴性与阳性患者、PR阴性与阳性患者、HER-2阴性与阳性患者的ADC值、D值、D*值、f值差异均无统计学意义(P>0.05),Ki-67高表达与低表达患者的D*值、f值差异无统计学意义(P>0.05)。Ki-67高表达患者的ADC值与D值均低于低表达者,差异有统计学意义(P<0.05)。ER、PR、HER-2分别与ADC值、D值、D*值、f值无相关性(P>0.05),Ki-67与D*值、f值无相关性(P>0.05),与ADC值和D值呈正相关性(P<0.05)。结论:IVIM-DWI定量参数ADC值、D值、D*值、f值可以为乳腺癌定性诊断提供有价值的依据,其中参数ADC值与D值在乳腺癌Ki-67高表达与低表达患者中存在统计学差异,可以为预测Ki-67表达提供参考。
关键词: 体素内不相干运动扩散加权成像序列;乳腺癌;诊断价值;免疫组织化学;相关性

Application of IVIM-DWI parameters in the diagnosis of breast cancer and its relationship with the expression of immunohistochemical indexes

Authors: 1ZHANG Juan, 1MIAO Chongchang, 1WANG Dehua, 1JIANG Shunbin, 1JIANG Keyi
1 Department of Imaging, Lianyungang Hospital, Xuzhou Medical University, Lianyungang Jiangsu 222000, China

CorrespondingAuthor: MIAO Chongchang Email: lygzhchmiao@163.com

DOI: 10.3978/j.issn.2095-6959.2022.04.017

Abstract

Objective: To study the application of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in the diagnosis of breast cancer and its relationship with the expression of immunohistochemical indicators. Methods: A retrospective analysis of 70 cases of suspected breast cancer admitted in our hospital from December 2019 to December 2020 was conducted. The Philips Ingenia 3 T superconducting MRI scanner and the mammary phased coils were used to detect the apparent diffusion coefficient (ADC) value, slow diffusion coefficient value (D value), fast diffusion coefficient value (D* value) and perfusion fraction value (f value) by imaging sequence setting. Meanwhile, the indexes of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 were detected. Results: Pathological examinations diagnosed 22 cases of benign tumors and 48 cases of malignant tumors; 54 cases were ER positive and 16 cases were negative; 50 cases were PR positive and 20 cases were negative; 55 cases had high expression of Ki-67 and 15 cases had low expression; 27 cases were positive for HER-2, 43 cases were negative. The ADC value, D value and D* value of malignant tumor patients were lower than those of benign tumor patients, and the f value was higher than that of malignant tumor patients, and the difference was statistically significant (P<0.05). There was no significant difference in ADC value, D value, D* value and f value between ER-negative and positive patients, PR-negative and positive patients, and HER-2-negative and positive patients (P>0.05). There was no significant difference in the D* value and f value of the expressing patients (P>0.05). The ADC and D values of patients with high Ki-67 expression were lower than those with low expression, and the difference was statistically significant (P<0.05). ER, PR, HER-2 had no correlation with ADC, D, D*, f values respectively (P>0.05), and Ki-67 had no correlation with D*, f values (P>0.05), but was positively correlated with ADC and D values (P<0.05). Conclusion: IVIM-DWI quantitative parameters ADC, D, D* and F values can provide a valuable basis for the qualitative diagnosis of breast cancer. There are statistical differences between the parameters ADC and D in the patients with high and low expression of Ki-67 in breast cancer, which can provide a reference for predicting the expression of Ki-67.
Keywords: intravoxel incoherent motion diffusion-weighted imaging sequence; breast cancer; diagnostic value; immunohistochemistry; correlation