Diagnostic Value Of Diffusion-weighted Imaging In Different Histopathological Type Of Breast Cancer And Axillary Nodal Metastasis

Objective: To detective the value of magnetic resonance diffusion weighted imaging(DWI) in different classical histopathological and immunohistochemical type of breast cancer and axillary lymph node metastasis. To evaluate the apparent diffusion coefficient(ADC)of axillary lymph node and the ratios of ADC between axillary lymph node and primary breast tumor in the detection of axillary lymph nodes metastasis in breast cancer patients.Materials and Methods: From Dec 2012 to Mar 2015,by collect in the hospital for breast dynamic contrast-enhanced scans and diffusion weighted imaging, a total of 60 patients with breast tumors and 115 axillary lymph nodes were retrospectively analyzed.All the diagnosis were confirmed by histopathological examination. Measured the short axial diameter of axillary lymph nodes. Calculated the ADC values using DWI software. The ADC values and the ADC ratios of axillary lymph nodes were compared between benign and metastatic axillary lymph nodes.Results: A significant difference was found in different classical histopathological and immunohistochemical type of breast cancer of ADC values.(P<0.05).The mean ADC value of metastatic lymph nodes(0.946×10-3 mm2/s)was lower than those of benign lymph nodes( 1.253×10-3 mm2/s±0.170)(P < 0.005).The ADC ratio of metastatic lymph nodes with breast lesion( 1.062±0.106)was significantly lower than those of benign lymph nodes( 1.355±0.153)(P <0.005). The cutoff of ADC was set at 1.085×10-3 mm2/s, the sensitivity, specificity, and accuracy respectively were 87.30%, 94.33% and 91.30%. The cutoff of ADC ratio was set at 1.205, the sensitivity, specificity, and accuracy were 93.65%, 86.79%,and 91.30%.Conclusion: The ADC value may be helpful for diagnosis of different classical histopathological and immunohistochemical type of breast cancer.ADC value and ADC ratio provid reliable and accurate parameters in detecting the axillary lymph nodes metastasis of breast cancer patients, and ADC ratio has a higher sensitivity than the ADC value.