乳腺MRI定量动态增强参数的重复性与一致性研究  

Repeatability and Agreement of Quantitative Perfusion Parameters on Dynamic Contrast-Enhanced MRI of Breast

作　　者：张艳秋[1] 刘万花[1] 孙甜甜 李丽环[1] 王瑞[1] 叶媛媛[1] 

机构地区：[1]东南大学附属中大医院放射科

出　　处：《临床放射学杂志》2018年第1期45-49,共5页Journal of Clinical Radiology

基　　金：973计划项目子课题基金资助项目(编号:2014CB744504)

摘　　要：目的探讨乳腺MRI定量动态增强参数的重复性和一致性。方法两位操作者,记为操作者1和操作者2,分别回顾性测量250例患者共256个乳腺病灶,所有病灶均术前行3.0 T乳腺MRI定量动态增强扫描,并经穿刺活检或手术病理证实,分别测量容量转移常数（Ktrans）、速率常数（Kep）和血管外细胞外间隙容积比（Ve）,并进行组间统计分析。运用配对t检验评估乳腺MRI各定量动态增强参数的差异性,运用组内相关系数（intraclass correlation coefficient,ICC）和Cronbach＇s Alpha系数评估其重复性,运用Bland-Altman分析乳腺MRI各定量动态增强参数的组间一致性。结果操作者1和操作者2测得的乳腺恶性病变各定量参数分别为K^（trans）（1.489±0.636）/min和（1.469±0.632）/min,K_（ep）（3.220±1.651）/min和（3.256±1.746）/min,Ve（0.504±0.152）/min和（0.517±0.162）/min;操作者1和操作者2测得的乳腺良性病变各定量参数分别为K^（trans）（0.429±0.236）/min和（0.443±0.251）/min,K_（ep）（0.769±0.431）/min和（0.794±0.463）/min,Ve（0.564±0.172）/min和（0.570±0.159）/min。不同操作者间乳腺恶性病变及良性病变的K^（trans）、K_（ep）及Ve值差异均无统计学意义（P〉0.05）;不同操作者间所测得的乳腺MRI各定量动态增强参数的ICC均在0.7以上,Cronbach＇s Alpha系数也均〉0.8,显示重复性较好。BlandAltman图像分析结果显示两个不同操作者之间所测得的乳腺MRI各定量动态增强参数的一致性较好。结论乳腺MRI定量动态增强参数的测量在不同操作者间具有较好的重复性和一致性,提示该技术具有可靠的临床指导价值。Objective To study the reproducibility and agreement of quantitative perfusion parameters on dynamic con- trast-enhanced MRI of breast lesions. Methods In this retrospective study, 250 breast patients with 256 breast lesions underwent 3.0T MRI examination before surgery and the quantitative MRI pharmacokinetic parameters ： the volume transfer constant （ Ktrans ）, rate constant （ Kop ） and extravascular extracellular volume fraction （ Vo ） value were measured by two operators i. e. operator 1 and operator 2 . Subsequently pathological characteristics were confirmed by pathology or biopsy. Data differences between the groups were compared by using a paired t-test. The repeatability of data was analyzed by intraclass correlation coefficient （ICC） and Cronbachg Alpha coefficients. The consistency of data was evaluated by Bland-Ahman analysis. Results The quantitative perfusion parameters on dynamic contrast-enhanced MRI of breast neoplasms measured by the operator 1 and the operator 2 were K （1. 489± 0. 636 ）/min and （1. 469 ± 0. 632 ）/min, Kep （3. 220 ± 1.651 ）/min and （ 3. 256 ± 1. 746 ）/min, Vo （ 0. 504 ± 0.152 ）/minand （ 0.517 ± 0. 162 ）/min. The quantitative perfusion parameters on dynamic contrast-enhanced MRI of breast benign lesions measured by the operator 1 and theoperator 2 were K （0. 429 ± 0. 236 ）/rain and （ 0. 443 ± 0.251 ）/rain, Kep （ 0. 769 ± 0.431 ）/min and （ 0. 794 ± 0. 463 ）/min, Ve （ 0. 564 ±0. 172）/min and（0. 570 ± 0. 159）/min. All quantitative perfusion parameters on dynamic contrast-enhanced MRI of breast lesions was not statistically significance between the two operators（ P 〉 0.05 ）. The ICC of all quantitative perfusion parameters on DCE-MRI of breast lesions were more than 0.7 and Cronbachg Alpha coefficients were more than 0.8 , which showed high intraobserver repeatability. Bland-Altman image analysis showed good consistency between two different operators. Conclusion The reproducibility of quantitative pe

关 键 词：乳腺 磁共振成像 重复性 一致性 

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]