乳腺磁共振成像动态对比增强定量参数在肿块良恶性鉴别诊断中的阈值及其应用价值  

Threshold and application value of DCE-MRI quantitative parameters in differential diagnosis of benign and malignant breast masses

作　　者：刘永天 周彦汝[2] 李国文 LIU Yongtian;ZHOU Yanru;LI Guowen(Basic Medical College of Zhengzhou University,Zhengzhou,Henan 450000,China;Department of MRI,the First Affiliated Hospital of Henan University of CM,Zhengzhou,Henan 450000,China;Department of Radiotherapy,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学基础医学院,河南郑州450000 [2]河南中医药大学第一附属医院磁共振室,河南郑州450000 [3]郑州大学第一附属医院放疗科,河南郑州450000

出　　处：《影像研究与医学应用》2022年第15期25-27,共3页Journal of Imaging Research and Medical Applications

基　　金：2021年河南省卫生健康委国家中医临床研究基地科研专项(2021JDZY095)。

摘　　要：目的:研究乳腺磁共振成像动态对比增强(DCE-MRI)定量参数在肿块良恶性鉴别诊断中的阈值及其应用价值。方法:回顾性分析河南中医药大学第一附属医院2020年8月—2021年8月收治的乳腺良恶性肿块病例91例的临床资料,包括良性肿块病例40例,恶性肿块病例51例,所有病例均有完整的病理及MRI检查资料。对照研究良恶性组肿块早期强化率、峰值强化率、早期强化比值、达峰时间,对有统计学意义的参数绘制受试者工作特征(ROC)曲线,确定其良恶性鉴别诊断阈值及敏感度、特异度。结果:良恶性组肿块早期强化率分别为(127±79)%、(129±47)%,差异无统计学意义(P=0.846);良恶性组肿块峰值强化率分别为(148±79)%、(131±47)%,差异无统计学意义(P=0.183);良恶性组肿块早期强化比值分别为75.52(67.96,100.00)%、100.00(100.00,100.00)%,差异有统计学意义(P<0.001);良恶性组肿块达峰时间分别为290(125,345)s、125(70,125)s,差异有统计学意义(P<0.001)。分别对肿块早期强化比值、达峰时间绘制ROC曲线,曲线下面积(AUC)分别为0.761、0.772。依据最大约登指数,肿块早期强化比值阈值为81.91%时,敏感度为98%,特异度为55%;肿块达峰时间为235 s时,敏感度为100%,特异度为55%。结论:乳腺DCE-MRI定量参数能较好地鉴别乳腺肿块的良恶性,早期强化比值以81.91%为阈值、达峰时间以235 s为阈值,对辅助鉴别肿块良恶性有一定的应用价值。Objective To study the threshold and application value of DCE-MRI quantitative parameters in differential diagnosis of benign and malignant breast masses.Methods A retrospective analysis was performed on 91 benign and malignant breast masses in the First Affiliated Hospital of Henan University of CM from August 2020 to August 2021,including 40 benign masses and 51 malignant masses.Complete pathological and MRI data of all cases were obtained.The early enhancement rate,peak enhancement rate,early enhancement ratio and peak time were studied in benign and malignant groups.The difference between groups was analyzed,and the ROC curve was drawn.The differential diagnosis threshold,sensitivity and specificity were determined.Results The early enhancement rates of benign and malignant groups were(127±79)%and(129±47)%,and there was no significant difference between the two groups(P=0.846).The peak enhancement rates of benign and malignant groups were(148±79)%and(131±47)%,and there was no significant difference between the two groups(P=0.183).The ratio of early enhancement was 75.52(67.96,100.00)%and 100.00(100.00,100.00)%in benign and malignant groups,and the difference was statistically significant(P<0.001).The peak time in benign and malignant groups was 290(125,345)s and 125(70,125)s,and the difference between the two groups was statistically significant(P<0.001).ROC curves were drawn for the ratio of early enhancement and peak time,and the area under the curve(AUC)was 0.761 and 0.772.When the ratio threshold of early enhancement was 81.91%,the sensitivity and specificity were 98%and 55%.When the peak time threshold was 235 s,the sensitivity and specificity were 100%and 55%.Conclusion DCE-MRI of breast can better differentiate benign and malignant masses,with early enhancement ratio as threshold value of 81.91%and peak time as threshold value of 253s,which has certain application value in the differential diagnosis of benign and malignant breast masses.

关 键 词：乳腺肿块 良恶性 磁共振成像 动态对比增强 

分 类 号：R445.2[医药卫生—影像医学与核医学]