基于CAIPIRINHA-Dixon-TWIST-VIBE技术动态增强MRI对乳腺病变的定量参数分析  

DCE-MRI with CAIPIRINHA-Dixon-TWIST-VIBE technique for breast lesions:quantitative analysis of pharmacokinetics parameters

作　　者：胡益祺 艾涛[1] 李嫣[1] 冯梦丹[1] 严序 徐潇 夏黎明[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,湖北武汉430030 [2]西门子医疗东北亚科研合作部,上海200000 [3]GE医疗(中国)药业部科学家团队,上海200000

出　　处：《影像诊断与介入放射学》2016年第2期98-101,共4页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金青年基金项目(81401388)

摘　　要：目的探究超快速并行采集技术(CAIPIRINHA)、水脂分离压脂技术(Dixon)及时间分辨交叉随机轨迹成像(TWIST)三种技术的容积插入法屏气扫描检查(VIBE)(CDT-VIBE)序列在超快速/高空间分辨率动态增强磁共振(DCEMRI)的可行性,并探究定量参数在乳腺病变鉴别诊断中的应用价值。方法对86例乳腺疾病的患者行3T DCE-MRI检查,采用4通道专用相控阵表面线圈,动态增强采用CDT-VIBE序列行35期扫描(空间分辨率为1 mm×1 mm×1.5 mm,时间分辨率为11.24 s)。测得所有病灶的血流动力学参数(K^(trans)、Ve、K_(ep))。对良恶性病变的定量参数进行T检验分析,并用ROC曲线对其进行诊断效能分析。结果采用CDT-VIBE序列的DCE-MRI可成功应用于病人的灌注扫描,其对于病灶边缘锐利度和内部结构特征显示较清晰。良性病变的定量参数K^(trans)、K_(ep)、Ve分别为0.22±0.11/ml、0.44±0.17/ml、0.51±0.09;恶性病变的定量参数K^(trans)、K_(ep)、V_e分别为(0.37±0.16/ml、(0.91±0.33)/ml、0.42±0.09。所有定量参数在良恶性病变之间均具有显著的统计学差异。K^(trans)诊断的敏感度、特异度、截断值、曲线下面积分别为92.3%、58.3%、0.193/ml、0.808;K_(ep)诊断的敏感度、特异度、截断值、曲线下面积分别为92.3%、75%、0.546/ml、0.922;Ve诊断的敏感度、特异度、截断值、曲线下面积分别为83.3%、66.7%、0.455/ml、0.743。结论:CDT-VIBE可以应用于乳腺高时间/空间分辨率的动态增强磁共振成像。由CDT-VIBE序列获取的定量参数K^(trans)、K_(ep)、Ve在病变诊断方面具有较高的敏感性及准确性,其中K_(ep)诊断效能最佳。Objective To investigate the feasibility of CAIPIRINHA-Dixon-TWIST-VIBE（CDT-VIBE） technique for ultrafast dynamic contrast-enhanced（DCE） MRI of breast lesions with high spatial resolution. Methods From June 2014 to March 2015,86 patients with 90 lesions（68 malignant and 22 benign） underwent DCE-MRI using a 3T system（Skyra, Siemens Healthcare）and 16-channel phased-array breast coil..The protocol was based on a work-in-progress CDT-VIBE sequence with spatial resolution of 1 mm ×1 mm ×1.5 mm and temporal resolution of 11.24 s for 35 phases after intravenous injection of 0.1 mmol / kg Gd-DTPA（Omniscan） at 2.5 ml/s. Quantitative pharmacokinetics parameters of K-（trans）,.K_（ep）and Ve were calculated for all breast lesions based on the Tofts model. Student＇s t test was performed to compare the differences of K-（trans）, K_（ep）and Ve between malignant and benign lesions followed by a ROC analysis for the diagnostic accuracy. Results DCE-MRI using the CDT-VIBE technique was successfully performed on all patients with superior delineation of margins and internal characteristics of breast lesions..The K-（trans）（0.22 ±0.11 / ml）,K_（ep）（0.44 ±0.17 / ml）.and Ve（0.51 ±0.09）.of benign lesions were significantly different from that of malignant lesions（0.37 ±0.16 / ml, 0.91 ±0.33 / ml, 0.42 ±0.09）. Based on ROC analysis, the sensitivity, specificity, optimal cut-off point and AUC were 92.3%, 58.3%, 0.193 / ml and 0.808 for K-（trans）; 83.3%, 66.7%, 0.455 and 0.743 for Ve; 92.3%, 75.0%, 0.546 /ml and 0.922 for K_（ep）. Conclusion The CDT-VIBE technique can be used for ultrafast high spatial resolution DCE-MRI of the breast..K-（trans）,.K_（ep）and Ve derived from CDT-VIBE sequence allowed for the classification of breast lesions with high sensitivity and accuracy. K_（ep） had the best performance for the differentiation of breast lesions, followed by K-（trans） and Ve.

关 键 词：乳腺癌 动态增强磁共振成像 高分辨率 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]