目的 探讨乳腺肿瘤的多参数MRI特征(T2-WI、ADC值和DCE)以及乳腺密度和背景实质增强(BPE)特征在不同乳腺癌(BC)分子亚型中的差异,以期为临床诊断提供重要参考.方法 本研究为回顾性研究,纳入344例患者.所有患者均接受了多参数乳房MRI(T2WI、ADC和DCE序列),并根据最新的BIRADS提取特征,使用ROI之间的类内系数(ICC)来评估读者间协议.结果 研究人群分为:luminal A 89例(26％),luminal B HER2阳性39例(11.5％),luminal B HER2阴性 168例(48.5％),三阴性(TNBC)41 例(12％),HER2富集7例(2％).Luminal 内A肿瘤与特殊的组织学类型、最小的肿瘤大小和持续的动力学曲线相关(P均＜0.05).Luminal B HER2阴性肿瘤与最低ADC值相关(0.77×10-3mm2/s2),其预测BC分子亚型的准确性为0.583.TNBC与不对称和中度/显著BPE,圆形/椭圆形肿块,边缘受限和边缘增强相关(P均＜0.05).HER2富集的BC与最大肿瘤大小相关(平均37.28mm,p值=0.02).结论 BC分子亚型与T2WI、ADC和DCE MRI特征相关,ADC有助于预测luminal BHER2阴性病例.
A Retrospective Study of Multi Parameter MRI Features of Molecular Subtypes of Breast Cancer
Objective To investigate the multi parameter MRI features(T2-WI,ADC value and DCE)of breast tumors,and the differences of breast density and background parenchyma enhancement(BPE)features in different molecular subtypes of breast cancer(BC).Methods This study is a retrospective study,involving 344 patients.All patients underwent multiparametric breast MRI(T2WI,ADC,and DCE sequences)and extracted features based on the latest BIRADS,using intra class coefficients(ICC)between ROIs to evaluate inter reader protocols.Results The study population was divided into 89 cases of luminal A(26％),39 cases of luminal B HER2 positive(11.5％),168 cases of luminal B HER2 negative(48.5％),41 cases of triple negative(TNBC)(12％),and 7 cases of HER2 enrichment(2％).Intraluminal A tumors are associated with specific histological types,smallest tumor size,and sustained dynamic curves(all P＜0.05).Luminal B HER2 negative tumors are associated with the lowest ADC value(0.77× The accuracy of predicting the subtypes of BC molecules is 0.583,with a size of 10-3mm2/s2.TNBC is associated with asymmetric and moderate/significant BPE,round/oval masses,restricted edges,and enhanced edges(all P＜0.05).HER2 enriched BC is correlated with the maximum tumor size(average 37.28 mm,P-value=0.02).Conclusion BC molecular subtypes are associated with T2WI,ADC,and DCE MRI features,and ADC is helpful in predicting lung B HER2 negative cases.
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