| Objectives To study the diagnostic value of magnetic resonance diffusion-weighted imaging(MR-DWI)in the clinical evaluation of breast cancer with axillary lymph node metastasis.Methods From March 2015 to March 2017 in Kailuan General Hospital,60 lymph nodes from 40 breast cancer patients were taken as the research object.All patients underwent breast MRI examination before operation and postoperative tissue samples were confirmed by pathological diagnosis.Using GE1.5TSigna HDxt superconducting MRI scanner and four-channel professional breast phased array coil,choose b value of 800 s/mm2 to compare the diffusion coefficient(ADC value)and the diameter of the short axis of metastatic axillary lymph nodes and non-metastatic axillary lymph nodes relevance,using the method of ROC curve drawing to get the threshold of ADC value and the sensitivity,specificity and accuracy of diagnosing metastatic lymph nodes.Results 1 Forty breast cancer patients,including 3 histological types according to histopathological type(2012 WHO classification),including 23 cases of invasive ductal carcinoma,11 cases of invasive lobular carcinoma,and 6 cases of ductal carcinoma in situ.Comparison of breast cancer ADCs of different pathological types found that,F=141.211,P=0.000 between groups,the difference was statistically significant.Further multiple comparisons revealed statistically significant differences between normal breast tissue and invasive ductal carcinoma,invasive lobular carcinoma,ductal carcinoma in situ,the differences were statistically significant(P=0.000,P=0.000,P=0.000);the differences between invasive ductal carcinoma,invasive lobular carcinoma,and ductal carcinoma in situ were statistically significant(P=0.002,P=0.000).2 Of the 60 breast cancer axillary lymph nodes,28 lymph nodes were positive for metastasis,accounting for 46.7%,and 32 were negative for lymph node metastasis,accounting for 53.3%.The diameter of the short axis of metastatic and non-metastatic lymph nodes after strict measurement were(10.57 ±2.81)mm and(8.11 ± 2.45)mm,respectively.The difference between the two was not statistically significant(t=1.143,P=0.317).3 The axillary metastatic lymph nodes of breast cancer mainly express high signals in DWI(b=800 s/mm2)images.The ADC value of metastatic negative lymph nodes is(1.088±0.21)×10-3 mm2/s,ADC value of metastatic positive lymph nodes(0.724±0.103)×10-3 mm2/s,ADC value of metastatic lymph nodes is significantly reduced,the difference between the two is statistically significant(t=7.251,P=0.000).4 Based on the measured ADC values,draw ROC curves for the ADC values of32 cases of lymph node metastasis-negative groups and 28 cases of lymph node metastasispositive groups,and the best diagnostic threshold for identifying the ADC value of benign and malignant lymph nodes in breast cancer is 0.914×10-3 mm2/s,the sensitivity for evaluating breast cancer axillary lymph node metastasis was 85.7%,the specificity was87.5%,and the accuracy was 86.7%.Conclusions 1 MR-DWI is helpful for the differential diagnosis of different pathological types of breast cancer.2 MR-DWI has high sensitivity,high specificity and high accuracy in assessing whether axillary lymph nodes are metastatic lymph nodes,and is safe,Noninvasive,rapid evaluation of imaging examination methods.Figure6;Table6;Reference 133... |
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