乳腺癌DCE-MRI量化参数与组织病理相关性分析  

The Correlation of Quantitative and Semi-Quantitative Parameters Obtained from Dynamic Contrast-Enhanced Magnetic Resonance Imaging with Histopathology in Human Breast Cancer

作　　者：罗红兵[1] 王闽[1] 周鹏[1] 青浩渺[1] 庞华容[1] 许国辉[1] 任静[1] 

机构地区：[1]四川省肿瘤医院.肿瘤研究所,成都610041

出　　处：《临床放射学杂志》2017年第7期952-957,共6页Journal of Clinical Radiology

摘　　要：目的探讨基于动态增强磁共振成像(DCE-MRI)及特定药物动力学模型所获得的量化参数与乳腺癌组织病理相关性。方法搜集61例乳腺癌患者DCE-MRI资料,通过后处理软件生成如下量化参数,定量参数:转移常数(K^(trans))、速率常数(K_(ep))、血浆分数(V_p);半定量参数:(1)增强扫描病灶达峰时间(TTP);(2)增强扫描病灶内对比剂最大浓度值(MAX Conc);(3)增强扫描时间信号曲线下面积(AUC);(4)增强扫描时间信号曲线最大斜率值(MAX Slope)。所有患者MRI检查后1周内经手术或穿刺活检取得病理结果。采用Kruskal-Wallis检验及Mann-Whitney U检验两两比较导管内癌组,非特殊类型浸润性癌组及特殊类型癌组间各量化参数的差异。采用Mann-Whitney U检验分析低组织学分级组(包括Ⅰ级和Ⅱ级)和高组织学分级组(Ⅲ级)、有淋巴结转移组和无淋巴结转移组间各量化参数的差异。结果 61例乳腺癌分为导管内癌组8例,非特殊类型浸润性癌组48例,特殊类型癌组5例。导管内癌组量化参数值K^(trans) Max=0.651(0.209 min^(-1))、K_(ep) Max=0.865(0.198)min^(-1)、K_(ep) Mean=0.270(0.021)min^(-1)明显小于特殊类型癌组量化参数值K^(trans) Max=1.390(0.846)min^(-1)、K_(ep)Max=2.169(1.122)min^(-1)、K_(ep)Mean=0.512(0.449 min^(-1)),P值分别为0.025、0.020、0.038。非特殊类型浸润性癌组量化参数Ktrans Max=0.740(0.078)min^(-1)、K_(ep)Mean=0.235(0.023)min^(-1)及MAX Conc Max=0.188(0.013)小于特殊类型癌组间量化参数K^(trans) Max=1.390(0.846)min^(-1)、K_(ep) Mean=0.512(0.449)min~(^(-1))及MAX Conc Max=0.385(0.238),P值分别为0.043、0.025、0.036。非特殊类型浸润性癌组根据组织学分级,分为低组织学分级组(包括Ⅰ级和Ⅱ级)34例,高组织学分级组(Ⅲ级)12例。根据淋巴结转移状态,分为无淋巴结转移组37例,有淋巴结转移组24例,结果显示较低分化组与高分化组、无淋巴结转移组与有淋巴结转移组间各量化参数间差�Objective To evaluate the correlation of quantitative and semi-quantitative parameters of Dynamic Contrast Enhanced MRI（ DCE-MRI） based on a certain pharmacokinetic modeling with histopathology in human breast cancer.Methods Sixty-one patients with breast cancer were enrolled from June 2015 to April 2016,All received DCE-MRI check and were confirmed by pathology in one week. The following quantitative parameters： volume transfer constant（ K^trans）,rate constant（ K（ep）） and the plasma fraction（ Vp） and semi-quantitative parameters： time to peak（ TTP）,max concentration（ MAX Conc）,area under curve（ AUC） were calculated; Cases were divided into three groups including ductal carcinoma in situ（ DCIS） group、non-special invasive carcinoma group and special carcinoma group according to histopathology result. The difference of these parameters between different pathology types of breast cancer were compared by Kruskal-Wallis and Mann-Whitney U test. Cases were assigned to one of two groups according to the lymph node status（ negative group vs. positive group）,histologic grade（ non-high group including grades 1 and 2 vs. high group including grade 3）,Mann-Whitney U test was used to compare the difference of these parameters between the two groups. Results 8 cases were diagnosed as ductal carcinoma in situ group,48 cases were non-special invasive carcinoma group,and 5 cases were special carcinoma group by pathology,The K^transMax、K（ep）Max、K（ep）Mean were lower in ductal carcinoma in situ group than those in special carcinoma group,and the K^transMax、K（ep） Mean、MAX Conc Max were lower in non-special invasive carcinoma group than those in special carcinoma group,all the difference is statistically different（ P〈0. 05）,while the other parameters show no statistical difference between the two groups. There were 34 cases of non-high group and 12 cases of high group according to histologic grade in non-special invasive carcinoma. 37 cases were assigned to ne

关 键 词：乳腺癌 磁共振成像 动态增强 病理 

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]