DCE-MRI定量参数K^(trans)、K_(ep)对乳腺良恶性病变的诊断价值  

Diagnostic value of DCE-MRI quantitative parameters K^(trans) and K_(ep) on benign and malignant breast lesions

作　　者：贾鹏[1] 张武[1] 卢禹[1] 陈龙华[1] JIA Peng;ZHANG Wu;LU Yu;CHEN Longhua(Department of Magnetic Resonance,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属医院磁共振科,河南南阳473000

出　　处：《右江医学》2021年第10期758-761,共4页Chinese Youjiang Medical Journal

摘　　要：目的探讨动态增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)乳腺病灶与背景实质定量参数对乳腺良恶性病变的诊断价值。方法收集2017年6月~2020年6月在作者医院接受DCE-MRI检查的乳腺病变患者60例,均获取病灶与背景实质的容量转移常数(volume transfer constant,K^(trans))、速率常数(rate constant,K_(ep))及血浆分数(plasma fraction,V_(p)),对比乳腺癌患者与良性病变患者上述参数的差异,并评价各参数对乳腺良恶性病变的诊断价值。结果60例患者均为单发病灶,其中乳腺癌26例,良性病变34例。乳腺癌组病灶与背景实质K^(trans)、K_(ep)水平均高于对照组(P<0.001);两组病灶与背景实质V_(p)水平比较差异无统计学意义(P>0.05)。病灶K^(trans)、K_(ep)诊断乳腺病变良恶性的ROC曲线下面积分别为0.751、0.694,背景实质K^(trans)、K_(ep)诊断乳腺病变良恶性的ROC曲线下面积分别为0.798、0.761;联合多参数的诊断效能提高,其曲线下面积为0.852,敏感度为94.67%,特异度为72.45%。结论DCE-MRI定量参数K^(trans)、K_(ep)有助于乳腺病变性质的鉴别诊断,尤其是背景实质的相关参数可能成为乳腺癌诊断的新手段。Objective To investigate the diagnostic value of breast lesions and background parenchymal quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI)in the diagnosis of benign and malignant breast lesions.Methods A total of 60 patients with breast lesions who underwent DCE-MRI in author's hospital between June 2017 and June 2020 were collected.Volume transfer constant(K^(trans)),rate constant(K_(ep))and plasma fraction(V_(p))of lesions and background parenchyma were obtained.And then,differences in the above-mentioned parameters were compared between patients with breast cancer and patients with benign lesions,and diagnostic value of each parameter on benign and malignant breast lesions was evaluated.Results 60 patients were all single lesions,including 26 cases of breast cancer and 34 cases of benign lesions.Levels of K^(trans) and K_(ep) of lesions and background parenchyma in breast cancer group were higher than those in control group(P<0.001).There were no statistically significant differences in V_(p) levels of lesions and background parenchyma between the two groups(P>0.05).Areas under the ROC curves of lesion K^(trans) and K_(ep) in the diagnosis of benign and malignant breast lesions were 0.751 and 0.694,respectively.The areas under the ROC curves of background parenchyma K^(trans) and K_(ep) in the diagnosis of benign and malignant breast lesions were 0.798 and 0.761,respectively.The combination of multiple parameters could improve diagnostic efficiency,and the area under the curve,sensitivity and specificity of which was 0.852,94.67%and 72.45%,respectively.Conclusion DCE-MRI quantitative parameters K^(trans) and K_(ep) are helpful for the differential diagnosis of breast lesions,especially the related parameters of background parenchyma may become new methods for the diagnosis of breast cancer.

关 键 词：乳腺肿瘤 磁共振成像 动态对比增强 对比剂 良恶性 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]