目的:评估组织细胞密度在良恶性乳腺病变弥散系数(Apparent Diffusion Coefficients,ADC)不同中所起的作用.材料和方法:对经手术病理证实的46例乳腺病变(恶性肿瘤26例,良性病变20例)进行磁共振弥散加权成像(Diffusion Weighted Imaging, DWI)检查,并计算病变的ADC值.用Adobe Photoshop 4.0 software 软件分析乳腺病变病理切片的细胞密度.统计分析ADC值与细胞密度的相关性.结果:恶性肿瘤平均ADC值为(0.9608±0.2043)×10-3mm2/s,明显小于良性病变组(1.5934±0.2084)×10-3mm2/s;P<0.001).恶性肿瘤平均细胞密度为(14.59±4.35)%,明显大于良性病变组(10.20±4.32%;P<0.05).乳腺病变ADC值与细胞密度的相关性很好(r=-0.542).结论:在乳腺良恶性肿瘤ADC不同中,细胞密度起了重要作用.通过测量肿瘤ADC鉴别乳腺良恶性病变是一个有效的方法,但仍有其局限性.
Purpose: To compare ADC with tumor cellularity to explore the possible role of cell density in different ADC of breast lesions. Materials and Methods: Diffusion weighted MR images were acquired using a multi section spin echo type single shot EPI sequence in the sagittal plane. 46 patients with histologically proven benign (20) and malignant (26) breast lesions were studied. Mean ADC value of the breast lesions was calculated. Tumor cellularity, analyzed using Adobe Photoshop 4.0 software, was defined as the total area of nuclei of tumor cells divided by the area of the histology section studied.10 fields of views (original magnification×200) of each lesion were analyzed. Statistical comparison of the tumor cellularity with the mean ADC was made using simple linear regression analysis. Results:Mean ADC (in units of 10 -3 mm 2/sec) of malignant lesions (0.9608±0.2043) was statistically different from that of benign lesions (1.5934±0.2084, P<0.001). Mean cellularity of malignant lesions [(14.59±4.35)%] was statistically different from that of benign lesions [(10.20±4.32)%](P<0.05). The mean ADC value of the breast lesions correlated well with tumor cellularity (r= -0.542). Conclusion:Cellularity plays a big role on different ADCs of malignant and benign breast tumors. Measuring the ADCs of focal breast masses is an effective but limited method for characterizing the masses.
Chinese Journal of Medical Imaging