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目的探讨早期乳腺癌在不同b值下的DWI成像特点及其ADC值改变、与Ki-67表达的相关性。方法对35例早期乳腺癌患者行MRI DWI检查,其b值分别取为500s/mm2、800s/mm2、1000s/mm2,分别测定癌灶在不同b值下扫描后的ADC均值,分析其DWI信号特点,比较其ADC值的差异性,并与术后病理Ki-67表达的相关性进行统计学分析。结果所有病例均为早期浸润性导管癌,瘤灶在DWI上均呈明显高信号。b值500s/mm2组(b-500组)与b值800s/mm2组(b-800组)、b-500组与b值1000s/mm2组(b-1000组)间ADC值存在统计学显著性差异(P值<0.05);而b-800组与b-1000组的ADC均值间无统计学显著性差异(P值>0.05)。b-500组、b-800组、b-1000组ADC均值分别为1.1416×10-3mm2/s、0.9258×10-3mm2/s、0.8668×10-3mm2/s。不同b值扫描后所测得瘤灶的三组ADC均值与Ki-67表达间的相关性均无统计学显著性差异(P>0.05)。结论早期乳腺癌不同b值下扫描所测得的ADC值间存在一定的差异性,选择b值为800s/mm2时扫描较为合理。当ADC值低于0.9258×10-3mm2/s时提示早期乳腺癌的可能。早期乳腺癌的ADC值与Ki-67表达之间无明显相关性。
Objective To investigate the characteristics of DWI at different b values and their ADC values in early breast cancer and the correlation with Ki-67 expression. Methods MRI DWI was performed in 35 patients with early breast cancer. The b values were taken as 500s / mm2, 800s / mm2, 1000s / mm2, respectively. The mean ADC values of the lesions after scanning at different b values were analyzed. The DWI signals The difference of ADC value was compared with that of pathological Ki-67 expression. Results All cases were early invasive ductal carcinomas, and the lesions showed markedly high signal on DWI. There was a statistically significant difference in ADC values between the b values of 500s / mm2 (b-500) and the b values of 800s / mm2 (b-800), b-500 and b of 1000s / mm2 (P <0.05). There was no significant difference between ADC values of b-800 group and b-1000 group (P> 0.05). The average ADC values of b-500 group, b-800 group and b-1000 group were 1.1416 × 10-3mm2 / s, 0.9258 × 10-3mm2 / s and 0.8668 × 10-3mm2 / s, respectively. There was no significant difference (P> 0.05) between the mean of ADC and the expression of Ki-67 in three groups of tumor detected by different b values. Conclusion There is a certain difference between the ADC values measured by scanning at different b values in early stage breast cancer. It is reasonable to select the scan with b value of 800s / mm2. When the ADC value is lower than 0.9258 × 10-3mm2 / s when prompted the possibility of early breast cancer. There was no significant correlation between ADC value and Ki-67 expression in early stage breast cancer.