动态增强MRI定量参数及最大线性斜率比值对鉴别乳腺良恶性疾病的价值  

The value of quantitative parameters of dynamic-enhanced MRI and the significance of the maximum Hnearity slope ratio in the differential diagnosis of benign and malignant breast lesions

作　　者：欧阳翼[1] 谢传淼[2] 伍尧泮[2] 吕衍春[2] 阮超美[2] 郑列[2] 彭康强[2] 何浩强[2] 陈林[2] 张伟章[2] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心放疗科,广州510060 [2]华南肿瘤学国家重点实验室中山大学医学影像及介入中心,广州510060

出　　处：《中华放射学杂志》2008年第6期569-572,共4页Chinese Journal of Radiology

摘　　要：目的通过对动态增强MR／时间-信号强度曲线（TIC）的后处理，寻找有效的鉴别诊断良、恶乳腺疾病的定量参数。方法回顾性分析行MR检查的30例乳腺疾病初诊患者，对动态增强MRI的TIC进行后处理，得出最高信号强度（Slmax）、强化峰值（PH）、最大线性斜率（Slope）、最大线性斜率比值（Slope^R）4个定量参数，用独立样本t检验和秩和检验评价4个定量参数在良、恶性病灶间的分布是否具有统计学意义。结果共17个良性病灶和18个恶性病灶，良性病灶和恶性病灶的Slmax值（M值）分别为375．2和158．1，95％可信区间分别为278．2～506．0和160．5～374．8；PH值（M值）分别为114．4和87．8，95％可信区间分别为73．7～196．5和71．3～162．9；Slope值（M值）分别为22．3×10。和44．0×10^-3，95％可信区间分别为13．7×10^-3～41．1×10^-3和46．1×10^-3～81．8×10^-3；Slope值（M值）分别为2．6和11．4，95％可信区间分别为1．9～3．4和9．8～14．5。Slmax、PH值在良、恶性病灶间的分布差异无统计学意义（P值均〉0．05）；Slope值在良、恶性病灶间的分布差异具有统计学意义（P〈0．01），但曲线下面积重叠较大；Slope^R值在良、恶性病灶间的分布差异具有统计学意义（P〈0．01），曲线下面积重叠少。结论Slope^R值对乳腺良、恶性病灶间的鉴别有重要意义。Objective To find the effective quantitative parameters for the differentiation of the breast lesions using the post-processing of time-signal curve of 3D dynamic-enhanced MRI. Methods Thirty patients with 35 lesions underwent 3D dynamic-enhanced MRI and the time-signal curve was deduced. The four quantitative parameters including SImax, PH, Slope and SlopeR were analyzed in benign and malignant lesions of the breast. Independent samples t test and rank sum test were used for the statistics. Results Seyenteen benign lesions and 18 malignant lesions were included in this study. The SImax （M） of benign and malignant lesions were 375.2 and 158. 1 ,the 95% confidence intervals of SImax were 278. 2-- 506.0 and 160. 5--374. 8. The PH （M） of benign and malignant lesions were 114.4 and 87.8 ,the 95% confidence intervals of PH were 73. 7--196. 5 and 71.3--162. 9. The Slope （M） of benign and malignant lesions were 22. 3 × 10^-3 and 44. 0 × 10^-3, the 95% confidence intervals of Slope were 13.7 × 10^-3 41.1×10^-3 and 46. 1 × 10^-3---81.8 × 10^-3. The SlopeR （M） of benign and malignant lesions were 2. 6 and ll.4,the 95% confidence intervals of SlopeR were 1.9--3.4 and 9. 8--14. 5. There were no significant differences on SImax and PH between benign and malignant lesions （ P 〉 0.05）. The significant differences existed on Slope （P 〈 0.01 ） and Slope^R （P 〈0.01 ） between benign and malignant lesions of the breast. Conclusion Slope^R is a very effective parameter in the differential diagnosis of breast lesions.

关 键 词：乳腺疾病 磁共振成像 图像增强 诊断 鉴别 

分 类 号：R686[医药卫生—骨科学]