Diagnostic value of magnetic resonance DWI and ADC in breast ductal carcinoma in situ with axillary lymph node metastasis

doi:10.3877/cma.j.issn.2095-5782.2024.03.008

Abstract

Abstract:

Objective

To investigate the diagnostic value of DWI and ADC in axillary lymph node (ALN) metastasis of breast ductal carcinoma in situ (DCIS) with micro-invasion (Mi).

Method

A total of 120 female patients who underwent conventional magnetic resonance imaging (MRI) scan, DWI and postoperative pathological results of DCIS-Mi in Anyang Cancer Hospital of Henan Province from February 2018 to March 2021 were included in the training set. In addition, 51 female DCIS-Mi patients admitted from November 2018 to August 2019 were included in the validation set. According to the results of postoperative pathological diagnosis, the patients in the training set were divided into the positive group (ALN metastasis) and the negative group (no ALN metastasis). In the training set, there were 17 cases in the positive group and 103 cases in the negative group. The patient's general clinical data and the ADC ALN texture feature in the figure were collected and compared between positive group and negative group. LASSO regression and Logistic regression analysis were used to screen the influencing factors. A nomogram model was constructed and evaluated based on the selected influencing factors. The correlation between independent factors and the risk of ALN metastasis in DCIS-Mi patients was analyzed using Spearman correlation analysis.

Result

Variation, skewness, kurtosis, 1%ADC value, 10%ADC value, energy, variance of sum, entropy of sum and entropy were independent factors affecting ALN metastasis in patients with DCIS-Mi (P < 0.05). The 1%ADC value was negatively correlated with the risk of ALN metastasis in DCIS-Mi patients (P < 0.05), while variation, skewness, kurtosis, 10%ADC value, energy, variance of sum, entropy of sum and entropy were positively correlated with the risk of ALN metastasis in DCIS-Mi patients (P < 0.05). The Nomogram model based on independent factors has high specificity, sensitivity and clinical applicability.

Conclusion

The Nomogram model based on ADC texture parameters is effective in predicting ALN metastasis in DCIS-Mi patients.

Key words: DCIS-Mi, Axillary lymph node metastasis, Magnetic resonance imaging, Diffusion weighted imaging, Apparent diffusion coefficient

Chao Jiang, Xudong Xia, Gongxia Wang, Xiangyu He, Haibin Wang, Yuan Li. Diagnostic value of magnetic resonance DWI and ADC in breast ductal carcinoma in situ with axillary lymph node metastasis[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(03): 234-243.

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Figures/Tables 10

References 25

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指标	阳性组（17例）	阴性组（103例）	F/t/χ²值	P值
年龄[例（%）]			0.403	0.526
< 45岁	9	46
≥45岁	8	57
组织学分级[例（%）]			4.199	0.123
低级别	2	22
中级别	6	52
高级别	9	29
原发灶肿瘤大小[例（%）]			0.235	0.628
< 2.5 cm	9	48
≥2.5 cm	8	55
浸润病灶数目[例（%）]			4.143	0.042
单个	8	74
≥2个	9	29
粉刺样坏死[例（%）]			0.840	0.360
是	2	22
否	15	81
脉管瘤栓[例（%）]			5.032	0.025
有	3	4
无	14	99
ER状态[例（%）]			3.996	0.046
阳性	11	40
阴性	6	63
PR状态[例（%）]			0.100	0.752
阳性	4	28
阴性	13	75
HER-2 [例（%）]			0.157	0.692
阳性	13	74
阴性	4	29
Ki-67指数[例（%）]			3.861	0.049
<20%	1	29
≥20%	16	74
变异度	286.51±30.36	205.83±25.81	11.642	< 0.001
均值	125.22±41.82	170.64±52.52	3.389	0.001
偏度	0.84±0.50	-0.25±0.63	6.781	< 0.001
峰度	0.23±0.07	-0.70±0.10	36.821	< 0.001
1%ADC值	75.52±29.31	127.24±35.14	5.742	< 0.001
10%ADC值	107.81±20.92	92.74±15.09	3.597	< 0.001
50%ADC值	130.79±31.05	115.86±25.27	2.183	0.031
90%ADC值	150.85±32.44	138.06±21.84	2.074	0.040
99%ADC值	162.56±34.86	145.62±29.13	2.159	0.033
能量（×10^-3）	30.86±7.29	14.85±5.33	10.851	< 0.001
对比度	9.43±3.72	11.32±4.15	1.763	0.080
相关	0.78±0.26	0.69±0.21	1.581	0.117
平方和	28.04±9.31	21.82±8.95	2.640	0.009
逆差距	0.28±0.13	0.34±0.16	1.467	0.145
均和	64.20±17.26	78.40±20.21	2.735	0.007
和方差	103.77±18.51	39.28±12.95	17.805	< 0.001
和熵	1.48±0.27	1.30±0.15	4.015	< 0.001
熵	1.96±0.33	1.44±0.26	7.342	< 0.001
差方差	3.87±0.95	4.22±1.23	1.118	0.266
差熵	0.80±0.22	0.76±0.15	0.947	0.345

指标	阳性组（17例）	阴性组（103例）	F/t/χ²值	P值
年龄[例（%）]			0.403	0.526
< 45岁	9	46
≥45岁	8	57
组织学分级[例（%）]			4.199	0.123
低级别	2	22
中级别	6	52
高级别	9	29
原发灶肿瘤大小[例（%）]			0.235	0.628
< 2.5 cm	9	48
≥2.5 cm	8	55
浸润病灶数目[例（%）]			4.143	0.042
单个	8	74
≥2个	9	29
粉刺样坏死[例（%）]			0.840	0.360
是	2	22
否	15	81
脉管瘤栓[例（%）]			5.032	0.025
有	3	4
无	14	99
ER状态[例（%）]			3.996	0.046
阳性	11	40
阴性	6	63
PR状态[例（%）]			0.100	0.752
阳性	4	28
阴性	13	75
HER-2 [例（%）]			0.157	0.692
阳性	13	74
阴性	4	29
Ki-67指数[例（%）]			3.861	0.049
<20%	1	29
≥20%	16	74
变异度	286.51±30.36	205.83±25.81	11.642	< 0.001
均值	125.22±41.82	170.64±52.52	3.389	0.001
偏度	0.84±0.50	-0.25±0.63	6.781	< 0.001
峰度	0.23±0.07	-0.70±0.10	36.821	< 0.001
1%ADC值	75.52±29.31	127.24±35.14	5.742	< 0.001
10%ADC值	107.81±20.92	92.74±15.09	3.597	< 0.001
50%ADC值	130.79±31.05	115.86±25.27	2.183	0.031
90%ADC值	150.85±32.44	138.06±21.84	2.074	0.040
99%ADC值	162.56±34.86	145.62±29.13	2.159	0.033
能量（×10^-3）	30.86±7.29	14.85±5.33	10.851	< 0.001
对比度	9.43±3.72	11.32±4.15	1.763	0.080
相关	0.78±0.26	0.69±0.21	1.581	0.117
平方和	28.04±9.31	21.82±8.95	2.640	0.009
逆差距	0.28±0.13	0.34±0.16	1.467	0.145
均和	64.20±17.26	78.40±20.21	2.735	0.007
和方差	103.77±18.51	39.28±12.95	17.805	< 0.001
和熵	1.48±0.27	1.30±0.15	4.015	< 0.001
熵	1.96±0.33	1.44±0.26	7.342	< 0.001
差方差	3.87±0.95	4.22±1.23	1.118	0.266
差熵	0.80±0.22	0.76±0.15	0.947	0.345

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