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目的:探讨磁共振扩散加权成像(diffusion-weighted imaging,DWI)表观扩散系数(apparent diffusion coefficient,ADC)直方图多参数与乳腺癌分子亚型的相关性.方法:回顾性分析本院2014年3月-2016年3月期间具有完整病理及术前MRI资料的182例浸润性导管癌(invasive ductal carcinoma,IDC)女性患者,术前行常规乳腺MRI平扫、扩散加权成像(b=50、800 s/mm2)及动态增强扫描(dynamic contrast-enhanced MRI,DCE-MRI),利用Firevoxel软件在DWI图上(b=800 s/mm2)绘制肿瘤每一层面感兴趣区(region of interest,ROI),记录整个肿瘤体积的ADC直方图参数,包括ADC最小值(ADCmin)、ADC10、ADC平均值(ADC-mean)、ADC中位数(ADCmedian)、ADC90、ADC最大值(ADCmax)、偏度系数、峰度系数,并同时生成ADC直方图.对不同亚型各ADC值进行Levene's检验验证方差齐性,方差齐时采用两样本t检验,方差不齐时采用Mann-Whitney U检验.使用Kruskal-Wallis或ANOVA检验比较IDC不同亚型与ADC值之间的关系.结果:除ADCmin以外,其他ADC参数在不同分子亚型IDC中均有统计学差异,在HER-2阳性组、Luminal A组、三阴性组、Luminal B组中降序排列,如ADC90平均值在4组中分别为1.501×10-3、1.401×10-3、1.330×10-3、1.223×10-3mm2/s,任何两组间有明显的统计学差异(HER-2阳性组和LuminalA组,LuminalA组和三阴性组,三阴性组和Luminal B组比较P值分别为0.019、0.035、＜0.001).结论:除ADCmin以外,不同ADC参数和乳腺癌分子分型有明显相关性,HER-2阳性组不同ADC参数值均高于其他组.“,”Objective:To investigate multiple apparent diffusion coefficient (ADC)histogram parameters that show correlations with different subtypes of invasive ductal carcinoma.Materials and Methods:From March 2014 to March 2016,a total of 182 invasive ductal carcinomas were included in this retrospective study.Various ADC histogram parameters were calculated including the entire tumor volume:the ADCmin,ADC10,ADC ADCmedian,ADC90,ADC skewness and kurtosis.The ADC multiple parameters of the histogram were calculated through Firevoxel software.The normality and homoscedasticity of imaging measures were tested using the Levene's tests.Data satisfying the assumption were subjected to ANOVA and independent-sample t test.Conversely,data not satisfying the assumption were analyzed by using the Kruskal-Wallis test and Mann-Whitney U test.The correlation between ADC parameters with different subtypes of invasive ductal carcinoma were analyzed.Results:For most ADC parameters except for ADCmin,the mean of variable ADC parameters of HER-2 positivity,Luminal A,triple-negative,and Luminal B diseases were arranged in descending order (e.g.1.501 × 10-3,1.401 × 10-3,1.330× 10-3,1.223 × 10-3 mm2/s in ADC90,respectively) with statistical significant difference (P=0.019,0.035,＜ 0.001,respectively).Conclusion:Various ADC parameters were correlated with prognostic factors and subtype,except for ADCmin.HER-2 positivity showed high ADC values than other subgroups.