MRS复合胆碱定量在鉴别乳腺肿瘤良恶性中的应用  

Application of total choline compound quantification in differentiating benign and malignant breast tumors

作　　者：姜蕾[1] 杜湘珂[1] 周诚[2] 陈敏[2] 纪立伟[2] 李波[2] 陆旭[2] 陈辉[2] 孙非[3] 申皓[3] 

机构地区：[1]北京大学人民医院放射科,北京100044 [2]北京医院,北京100730 [3]GE公司磁共振产品技术部,北京100176

出　　处：《中国临床医学影像杂志》2008年第11期769-771,778,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨乳腺肿瘤中复合胆碱(tCho)浓度对鉴别病变良恶性的价值。材料和方法:研究对象为最短径大于1cm的乳腺肿瘤36例,包括27例乳腺癌及9例纤维腺瘤。对36例乳腺肿瘤病人进行乳腺MRS采集,采用外参照法对乳腺肿瘤中的tCho浓度进行定量(利用校对公式以胆碱模型中的胆碱浓度为参照计算出乳腺肿瘤中tCho的浓度)。比较良恶性乳腺肿瘤的tCho浓度。ROC曲线分析用tCho浓度鉴别肿瘤良恶性的价值。结果:乳腺癌组的tCho浓度为(4.28±2.93)mM,纤维腺瘤组的tCho浓度为(0.09±0.27)mM,二者有显著统计学差异。应用MRS胆碱浓度判断乳腺肿瘤良恶性的ROC曲线下面积为0.979±0.24,若以0.99mM作为良恶性病变之间的阈值则敏感性和特异性分别为96.3%、100%。结论:应用tCho浓度来鉴别乳腺肿瘤的良恶性是可行的,对于病灶短径大于1cm的肿瘤有较高的敏感性和特异性。Objective： To investigate the value of tCho concentration in differentiating benign and malignant breast tumors. Materials and Methods： Thirty-six breast tumors （27 breast cancers and 9 fibroadenomas） were studied. MR spectra of 36 breast tumors were obtained and tCho concentrations were quantified with choline phantom as the external standard, tCho concentrations of benign and malignant breast tumors were compared. ROC curve was used to analyze the value of tCho concentration in differentiating benign and malignant tumors. Results： The tCho concentrations of breast cancers and fibroadenomas were （4.28±2.93）mM and （0.09±0.27）mM respectively. Significant difference was found between them. The area under ROC curve was 0.979±0.24. Taking 0.99mM as the threshold, the sensitivity and specificity were 96.3%, 100% respectively. Conelusions： Differentiation between benign and malignant breast tumors with tCho concentration was applicable an for tumors larger than 1cm, the sensitivity and specificity were relatively high.

关 键 词：乳腺肿瘤 磁共振波谱学 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]