高时间分辨率动态对比增强MRI定量分析乳腺良恶性病变的价值  

The value of high temporal resolution dynamic contrast-enhanced MRI in quantitative analysis of benign and malignant breast lesions

作　　者：刘玉凤[1] 李嘉颖 王世威[1] 渠静静 肖凤春 王春丹[2] LIU Yufeng;LI Jiaying;WANG Shiwei;QU Jingjing;XIAO Fengchun;WANG Chundan(Department of Medical Imaging,the First Affiliated Hospital of Zhejiang Chinese Medicine University,Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,China;Department of Pathology,the First Affiliated Hospital of Zhejiang Chinese Medicine University,Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,China)

机构地区：[1]浙江中医药大学附属第一医院(浙江省中医院)医学影像科,浙江杭州310006 [2]浙江中医药大学附属第一医院(浙江省中医院)病理科,浙江杭州310006

出　　处：《实用放射学杂志》2021年第11期1805-1809,共5页Journal of Practical Radiology

基　　金：浙江省卫生厅平台骨干项目(2016147237);浙江省中医药科技计划项目(2018ZB048)。

摘　　要：目的探讨高时间分辨率动态对比增强磁共振成像(DCE-MRI)定量分析乳腺良恶性病变的价值。方法前瞻性选取105例乳腺疾病患者,其中56例符合入组标准,术前行高时间分辨率DCE-MRI。容积测量并通过血流动力学双室模型定量分析其参数,采用受试者工作特征(ROC)曲线评价其诊断效能。结果良、恶性组的平均容积转运常数(K^(trans)-mean)、平均速率常数(K_(ep)-mean)、平均细胞内容积比(V_(p)-mean)、平均达峰时间(TTP-mean)有统计学差异(P<0.05),秩和检验显示K^(trans)-mean、K_(ep)-mean、TTP-mean在浸润性导管癌(IDC)不同病理等级间有统计学差异(P<0.05);Spearman分析显示IDC的K^(trans)-mean、K_(ep)-mean、TTP-mean与IDC不同病理等级相关。二元Logistic回归分析显示K_(ep)-mean有助于鉴别乳腺病灶良恶性。结论高时间分辨率DCE-MRI能通过K^(trans)-mean、K_(ep)-mean、V_(p)-mean、TTP-mean鉴别乳腺良恶性病变,K^(trans)-mean、K_(ep)-mean、TTP-mean有助于评估IDC病理等级。Objective To explore the value of high temporal resolution dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in quantitative analysis of benign and malignant breast lesions.Methods This study prospectively enrolled 105 patients with clinically suspected breast lesions.Among them,56 patients underwent preoperative high temporal resolution DCE-MRI.Quantitative parameters were obtained using a two-compartment extended tofts and volume of interest model for the lesion center.The diagnostic performance was evaluated by the receiver operating characteristic(ROC)curve.Results The mean of volume transfer constant(K^(trans)-mean),the mean of rate constant(K_(ep)-mean),the mean of fractional plasma volume(V_(p)-mean)and the mean of time to peak(TTP-mean)had statistical differences between benign and malignant groups(P<0.05).Spearman analysis showed that the K^(trans)-mean,K_(ep)-mean,and TTP-mean were related to the different pathological grades of invasive ductal carcinoma(IDC).Binary Logistic regression analysis displayed that the K_(ep)-mean was helpful to distinguish the benign from malignant breast lesions.Conclusion The high temporal resolution DCE-MRI can differentiate the benign from malignant breast lesions using K^(trans)-mean,K_(ep)-mean,V_(p)-mean,and TTP-mean.K^(trans)-mean,K_(ep)-mean and TTP-mean will be helpful to assess the pathological grade of IDC.

关 键 词：乳腺 动态对比增强磁共振成像 高时间分辨率 定量分析 

分 类 号：R655.8[医药卫生—外科学] R737.9[医药卫生—临床医学]