动态对比增强MRI在良恶性乳腺肿瘤诊断中的研究  

Dynamic Contrast-enhanced MRI in the Diagnosis of Benign and Malignant Breast Tumors

作　　者：梁家宁[1] Liang jianing(First People's Hospital in Zhaoqing City)

机构地区：[1]肇庆市第一人民医院MR室,广东肇庆526020

出　　处：《现代医用影像学》2019年第5期961-963,968,共4页Modern Medical Imageology

摘　　要：目的:探讨动态对比增强(DCE)MRI在良恶性乳腺肿瘤中的诊断价值。方法:选取2017年10月～2018年12月期间,我院收治的132例乳腺肿瘤患者(共144个病灶)作为研究对象。所有患者均行术前DCE-MRI检查,并经手术切除治疗。根据术中病理结果,将患者分为恶性乳腺肿瘤组(102例,共110个病灶)和良性乳腺肿瘤组(30例,共34个病灶)。根据感兴趣区(ROI),获得容量转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积分数(V_e)和血浆分数(V_p)。对比两组患者病灶上述指标差异,并绘制差异指标的受试者工作特征曲线(ROC),计算曲线下面积(AUC),分析DCE-MRI在良恶性乳腺肿瘤中的诊断价值。结果:恶性乳腺肿瘤组患者K^(trans)、K_(ep)值均高于良性乳腺肿瘤组,差异均具有统计学意义(P<0.05),两组患者V_e、V_p比较,差异无统计学意义(P>0.05)。K^(trans)诊断乳腺肿瘤性质的AUC为0.934,95%CI:0.894～0.974,当约登指数最大为0.700时,灵敏度为0.700,特异度为1.000,此时K^(trans)最佳诊断值为0.255/min。K_(ep)诊断乳腺肿瘤性质的AUC为0.953,95%CI:0.918～0.988,当约登指数最大为0.737时,灵敏度为0.855,特异度为0.882,此时K_(ep)最佳诊断值为0.393/min。结论:DCE-MRI检查中,K^(trans)、K_(ep)指标可作为判断乳腺肿瘤性质的参考指标,具有一定的临床应用价值。Objective: To investigate the diagnostic value of dynamic contrast-enhanced (DCE) MRI in benign and malignant breast tumors.Methods: From October2017 to December2018,132 breast cancer patients (144 lesions) admitted to our hospital were selected as subjects.All patients underwent preoperative DCE-MRI and were surgically resected.According to the intraoperative pathological results,the patients were divided into malignant breast tumor group (102 cases,a total of110 lesions) and benign breast tumor group (30 cases,a total of34 lesions).Volume transfer constant (K trans ),rate constant (K ep ),the volume fraction of extravascular extracellular space (V e),and the volume fraction of plasma (V p) were obtained according to the region of interest (ROI).The differences of the above indexes between the two groups were compared,and the receiver operating characteristic curve (ROC) of the difference index was drawn.The area under the curve (AUC) was calculated and the diagnostic value of DCE-MRI in benign and malignant breast tumors was analyzed.Results: The K trans and K ep values in the malignant breast tumor group were higher than those in the benign breast tumor group (P<0.05).There was no significant difference in the V e and V p between the two groups (P>0.05).The AUC of K trans for the diagnosis of breast tumors was 0.934,95% CI: 0.894~0.974.When the Yoden index was 0.700,the sensitivity was 0.700 and the specificity was1.000.The optimal diagnosis value of K trans was 0.255/min.The AUC of K ep diagnosis of breast tumors was 0.953,95% CI: 0.918~0.988.When the Yoden index was 0.737,the sensitivity was 0.855 and the specificity was 0.882.The best diagnostic value of K ep was 0.393/min.Conclusion: In the DCE-MRI examination,the K trans and K ep indicators can be used as reference indicators for judging the nature of breast tumors, and have certain clinical application value.

关 键 词：动态对比增强 磁共振成像 乳腺癌 受试者工作特征曲线 诊断 

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