Diffusion-Weighted Imaging of Mucinous Carcinoma of the Breast: Evaluation of Apparent Diffusion Coefficient and Signal Intensity in Correlation With Histologic Findings
Diffusion-Weighted Imaging of Mucinous Carcinoma of the Breast: Evaluation of Apparent Diffusion Coefficient and Signal Intensity in Correlation With Histologic Findings
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DOI：
10.2214/ajr.08.1670
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发表时间：
2009-07-01
影响因子：
5
通讯作者：
Hatabu, Hiroto
中科院分区：
文献类型：
--
作者：
Woodhams, Reiko;Kakita, Satoko;Hatabu, Hiroto
目标。本研究的目的是比较乳腺黏液性癌与乳腺其他肿瘤的表观弥散系数（ADC），并分析弥散加权图像信号强度与黏液性癌组织学特征的相关性。研究对象和方法。对276例患者277个病变进行1.5 t MRI检查，其中粘液癌15例（单纯型13例，混合型2例），其他恶性肿瘤204例，良性病变58例（b值分别为0和1500 s/mm）。分析细胞结构与ADC之间的相关性、扩散加权图像上信号强度的均匀性以及组织病理学结果。差异有统计学意义（p < 0.05）。粘液癌的平均ADC (1.8 +/- 0.4 × 10（-3) mm(2)/s）高于良性病变(1.3 +/- 0.3 × 10（-3) mm(2)/s）和其他恶性肿瘤(0.9 +/- 0.2 × 10(-3) mm(2)/s)，差异有统计学意义（p < 0.001）。单纯型黏液性癌的ADC (1.8 +/- 0.3 × 10（-3) mm(2)/s）高于混合型黏液性癌(1.2 +/- 0.2 × 10(-3) mm(2)/s) （p < 0.001）及其他组织学类型（p < 0.05）。平均细胞数与黏液癌ADC的相关性有统计学意义(rho(s) = -0.754；P = 0.001)。弥散加权图像信号强度的均匀性与黏液癌组织结构的均匀性相关（p < 0.001; kappa = 0.826）。黏液癌可根据ADC与其他乳腺肿瘤明确区分。粘液癌在弥散加权图像上的低信号强度似乎反映了粘蛋白和低细胞的存在。弥散加权图像上的高信号强度可能反映纤维维管束的存在，细胞密度增加，或这些特征的组合。
OBJECTIVE. The purposes of this study were to compare the apparent diffusion coefficient ( ADC) of mucinous carcinoma of the breast with that of other breast tumors and to analyze correlations between signal intensity on diffusion-weighted images and the histologic features of mucinous carcinoma.SUBJECTS AND METHODS. Two hundred seventy-six patients with 277 lesions, including 15 mucinous carcinomas ( 13 pure type, two mixed type), 204 other malignant tumors, and 58 benign lesions, were examined with 1.5-T MRI at b values of 0 and 1,500 s/mm(2). The correlations between cellularity and ADC, homogeneity of signal intensity on diffusion-weighted images, and histopathologic findings were analyzed. The difference was statistically significant (p < 0.05).RESULTS. The mean ADC of mucinous carcinoma (1.8 +/- 0.4 x 10(-3) mm(2)/s) was statistically higher than that of benign lesions (1.3 +/- 0.3 x 10(-3) mm(2)/s) and other malignant tumors (0.9 +/- 0.2 x 10(-3) mm(2)/s) (p < 0.001). The ADC of pure type mucinous carcinoma ( 1.8 +/- 0.3 x 10(-3) mm(2)/s) was higher than that of mixed type mucinous carcinoma (1.2 +/- 0.2 x 10(-3) mm(2)/s) (p < 0.001) and other histologic types (p > 0.05). The correlation between mean cellularity and the ADC of mucinous carcinoma was significant (rho(s) = -0.754; p = 0.001). The homogeneity of signal intensity on diffusion-weighted images correlated with the homogeneity of histologic structures of mucinous carcinoma (p < 0.001; kappa = 0.826).CONCLUSION. Mucinous carcinoma can be clearly differentiated from other breast tumors on the basis of ADC. The low signal intensity of mucinous carcinoma on diffusion-weighted images appears to reflect the presence of mucin and low cellularity. High signal intensity on diffusion-weighted images may reflect the presence of fibrovascular bundles, increased cell density, or a combination of these features.