3.0TMR动态增强扫描在乳腺癌早期诊断中的应用  

Application of 3.0TMR dynamic contrast-enhanced scan in the early diagnosis of breast cancer.

作　　者：高云展 崔涛涛[2] 张桀瑞 吴霞霞 吴昳 GAO Yun-zhan;CUI Tao-tao;ZHANG Jie-rui;WU Xia-xia;WU Yi(Department of Radiology,Yan'an People's Hospital,Yan'an 716000,Shaanxi,CHINA;Department of CT Diagnosis,Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA)

机构地区：[1]延安市人民医院放射科,陕西延安716000 [2]延安大学附属医院CT诊断科,陕西延安716000

出　　处：《海南医学》2021年第6期742-746,共5页Hainan Medical Journal

摘　　要：目的研究3.0TMR平扫及动态增强扫描(DCE)在乳腺癌早期诊断中的应用价值。方法回顾性分析2016年10月至2019年10月延安市人民医院收治的182例女性乳腺疾病患者的临床资料,根据病理结果分为乳腺癌组109例和良性病变组73例,所有患者均接受横断位T1WI、抑脂T2加权成像(fs-T2WI)和DCE扫描,观察病灶形态特征,计算转运常数(Ktrans)、回流速率常数(Kep)以及容积分数(Ve)等血流参数并进行比较,另根据恶性程度将乳腺癌组患者分为低度恶性组67例和高度恶性组42例,比较两组Ktrans、Kep和Ve,采用受试者工作特征曲线(ROC)分析Ktrans、Kep和Ve对乳腺癌诊断和恶性程度评估价值。结果与良性病变组比较,乳腺癌组患者的病灶形状不规则、血管影增多、边界模糊、毛刺征及强化不均匀占比明显升高,差异均有统计学意义(P<0.05);DCE扫描显示乳腺癌病灶TIC分型以Ⅱ型(33.94%)和Ⅲ型(58.72%)为主;乳腺良性病变TIC分型主要表现为Ⅰ型(69.86%)和Ⅱ型(24.66%),两者强化类型比较差异有统计学意义(P<0.05);乳腺癌组患者的Ktrans、Kep和Ve明显高于良性病变组,且高度恶性乳腺癌组患者的Ktrans、Kep和Ve明显高于低度恶性组,差异均有统计学意义(P<0.05);Ktrans、Kep和Ve诊断乳腺癌的AUC分别为0.771、0.823和0.865,鉴别乳腺癌恶性程度的AUC分别为0.740、0.796和0.695。结论3.0T DCE-MRI用于乳腺癌早期诊断不仅可清晰显示肿瘤病灶形态特征和强化形式,通过计算Ktrans、Kep和Ve等参数还可对病灶血流特征进行定量分析,为临床诊断提供详细参考信息。Objective To study the application value of 3.0TMR plain scan and dynamic contrast-enhanced scan(DCE)in the early diagnosis of breast cancer.Methods The clinical data of 182 female patients with breast diseases in Yan’an People’s Hospital from October 2016 to October 2019 were retrospectively analyzed.According to the pathological results,they were divided into breast cancer group(109 cases)and benign lesion group(73 cases).All patients received transverse T1WI and lipid-suppressing T2 weighted imaging(fs-T2WI)and DCE scan.Morphological characteristics of the lesions were observed,and blood flow parameters such as transport constant(Ktrans),reflux rate constant(Kep),and volume fraction(Ve)were calculated and compared.According to the degree of malignancy,patientsin breast cancer group were divided into low malignancy group(67 cases)and high malignancy group(42 cases),and Ktrans,Kep and Ve were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the value of Ktrans,Kep and Ve in the diagnosis of breast cancer and assessment of malignancy degree.Results Compared with benign lesion group,the proportions of irregular lesion shape,increased vascular shadows,blurred borders,burr signs,and uneven enhancement were significantly increased in breast cancer group(P<0.05).DCE scan showed that TIC classification of breast cancer lesions were mainly typeⅡ(33.94%)and typeⅢ(58.72%).TIC classification of benign breast lesions were mainly typeⅠ(69.86%)and typeⅡ(24.66%),and there was a significant difference between the two types of enhancement(P<0.05).The Ktrans,Kep,and Ve of patients in breast cancer group were higher than those of patients in benign lesion group,and the Ktrans,Kep,and Ve of patients in high malignancy of breast cancer group were higher than those of patients in low malignancy group(P<0.05).The AUC values of Ktrans,Kep,and Ve in the diagnosis of breast cancer were 0.771,0.823,and 0.865,and the AUC values in identifying the malignancy degree of breast cancer

关 键 词：乳腺癌 磁共振成像 动态增强扫描 转运常数 回流速率常数 容积分数 诊断 

分 类 号：R737.9[医药卫生—肿瘤]