Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Usefulness of Diffusion-Weighted MR Imaging for Breast Lesions: Comparing the Apparent Diffusion Coefficient (ADC) Values and the Pathologic Results

유방 병변에서 확산강조자기공명영상의 유용성: 겉보기확산계수값과 병리 결과의 비교

  • Ahn, Hye-Shin (Department of Radiology, Soonchunhyang University Hospital) ;
  • Chang, Yun-Woo (Department of Radiology, Soonchunhyang University Hospital) ;
  • Choi, Kyung-Hee (Department of Radiology, Soonchunhyang University Hospital) ;
  • Kim, Hyun-Joo (Department of Radiology, Soonchunhyang University Hospital) ;
  • Hong, Seong-Sook (Department of Radiology, Soonchunhyang University Hospital) ;
  • Hwang, Jung-Hwa (Department of Radiology, Soonchunhyang University Hospital) ;
  • Kwon, Kui-Hyang (Department of Radiology, Soonchunhyang University Hospital) ;
  • Kim, Yong-Bae (Department of Preventive Medicine, Soonchunhyang University Hospital)
  • 안혜신 (순천향대학교병원 영상의학과) ;
  • 장윤우 (순천향대학교병원 영상의학과) ;
  • 최경희 (순천향대학교병원 영상의학과) ;
  • 김현주 (순천향대학교병원 영상의학과) ;
  • 홍성숙 (순천향대학교병원 영상의학과) ;
  • 황정화 (순천향대학교병원 영상의학과) ;
  • 권귀향 (순천향대학교병원 영상의학과) ;
  • 김용배 (순천향대학교병원 예방의학과)
  • Published : 2011.04.01
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Abstract

Purpose: We wanted to evaluate the ability of the apparent diffusion coefficient (ADC) values to differentiate between benign and malignant breast lesions and the normal breast parenchyma. Materials and Methods: We used breast MRI, including DWI, to obtain images of 167 breast lesions (18 benign lesions and 149 malignant lesions) of 152 women (mean age: 48.6 years, range: 24-80 years). The mean ADC values of the malignant lesions were compared to those of the benign lesions and the normal parenchyma. We compared the ADC values of IDC, DCIS and other types of breast cancer and we also compared the ADC values with the nuclear grade of IDC. Results: The mean ADC values of the malignant lesions were lower than those of the benign lesions and the normal parenchyma (p<0.001, respectively). The mean ADC value of IDC was lower than those of DCIS and other breast cancers (p<0.001, respectively). The mean ADC value of mucinous carcinoma among the other breast cancer was characteristic high compared with that of the normal parenchyma. There was no significant differentiation of the ADC values between the nuclear grades of IDC (p<0.828). The ADC threshold value of $0.98{\times}10^{-3}mm^2/s$ for discriminating between malignant and benign lesion showed a specificity of 53% and a sensitivity of 100%, and the ADC threshold value of $1.33{\times}10^{-3}mm^2/s$ showed a specificity of 93% and a sensitivity of 94% for discriminating between malignant and benign lesion. Conclusion: The ADC value is significantly different between the different pathological results of breast lesions.

목적: 유방의 악성, 양성, 정상 유선 조직 및 유방암의 조직학적 분류에 따른 겉보기확산계수(apparent diffusion coefficient, 이하 ADC)값의 차이를 알아보고자 하였다. 대상과 방법: 유방암 수술 전 유방 자기공명영상을 시행한 여자환자 중 확산강조영상에서 유방병변을 보인 152명의(평균 연령: 48.6세, 연령 범위: 24-80세) 167개 병변을 대상으로 하였다. 병리적으로 확진된 악성 병변 149예와 양성 병변 18예의 ADC 값이 계산되었다. 악성, 양성 병변 및 정상 유선조직의 ADC 값을 비교하였으며 악성 병변 중 침윤유방암종, 관상내피암, 기타 유방암의 ADC 값을 비교하였다. 침윤유방암종의 핵등급에 따른 ADC 값을 비교하였다. 결과: 악성 병변의 평균 ADC 값은 양성 병변과 정상 유선조직보다 통계적으로 유의하게 낮았다(p < 0.001). 침윤유방암종의 평균 ADC 값은 관상피내암과 기타 유방암과 비교하여 통계적으로 유의하게 낮았다(p < 0.001). 기타 유방암 중 점액암종은 특징적으로 정상 유선조직보다 높은 평균 ADC 값을 보였다. 침윤유방암종의 핵등급에 따른 평균 ADC 값은 통계적으로 유의한 차이가 없었다(p < 0.828). ADC 값의 양성과 악성을 구분하는 한계값이 $0.98{\times}10^{-3}mm^2/s$일 때 민감도는 100%, 특이도는 53%였으며 $1.33{\times}10^{-3}mm^2/s$일 때는 민감도는 94%, 특이도는 93%였다. 결론: 확산강조영상의 ADC 값은 유방의 병리소견에 따라 의미 있는 차이를 보였다.

Keywords

References

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