动态对比增强磁共振联合弥散加权成像检查与浸润性乳腺癌预后因素的相关性研究  被引量:15

Study on the correlation between DCE-MRI combined with DWI detection and prognostic factors of IBC

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作  者:徐晓伟 赖建钟 林雪鸿 钟华成[1] XUXiao-wei;LAI Jian-zhong;LIN Xue-hong(Department of Medical Imaging,The 909th Hospital of People’s Liberation Army Joint Service Support Force(Southern and Eastern Hospital Affiliated to Xiamen University),Zhangzhou 363000,China)

机构地区:[1]联勤保障部队第九〇九医院(厦门大学附属东南医院)医学影像科,福建漳州363000

出  处:《中国医学装备》2022年第10期53-58,共6页China Medical Equipment

基  金:福建省科学技术厅项目(ZZ2016J22)“DCE-MRI联合DWI检测与浸润性乳腺癌预后因素的相关性”。

摘  要:目的:分析动态对比增强磁共振成像(DCE-MRI)联合弥散加权成像(DWI)检查与浸润性乳腺癌(IBC)预后因素的相关性。方法:选择医院收治的100例女性乳腺癌患者,均行常规乳腺MRI平扫后进行DCE-MRI检查及DWI检查,统计IBC患者肿瘤最大直径、淋巴结转移、组织学分级等预后因素,采用常规免疫组化链霉素抗生物素蛋白-过氧化物酶(SP)法对乳腺癌患者雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)及Ki67抗原(Ki-67)进行检测。采用Pearson线性相关分析各因子水平变化的相关性,测定对比剂的容量转移常数(K^(trans))、速率常数(K_(ep))。结果:IBC患者的不同肿瘤最大直径、淋巴结转移、远处转移、组织学分级、ER以及PR表达的K^(trans)水平比较,差异具有统计学意义(Z=12.35,Z=1.71,Z=1.83,Z=4.28,Z=6.34,Z=5.86;P<0.05);不同肿瘤最大直径、远处转移、组织学分级、ER以及PR表达的K_(ep)水平比较,差异具有统计学意义(Z=6.81,Z=1.72,Z=6.42,Z=5.68,Z=5.71;P<0.05);不同肿瘤最大直径、淋巴结转移、远处转移、组织学分级、ER、PR以及HER-2表达的表观弥散系数(ADC)值b=500和ADC值b=1000水平差异具有统计学意义(x^(2)_(b=500)=3.78,x^(2)=4.65,x^(2)=3.65,x^(2)=4.71,x^(2)=6.85,x^(2)=5.81,x^(2)=4.85;x^(2)_(b=100)0=3.28,x^(2)=5.67,x^(2)=5.17,x^(2)=4.92,x^(2)=3.87,x^(2)=3.84,x^(2)=3.19;P<0.05)。DCE-MRI检查中,K^(trans)和K_(ep)与肿瘤最大直径、淋巴结转移、远处转移以及组织学分级均呈明显正相关(rK^(trans)=0.516,r=0.492,r=0.516,r=0.389;rK_(ep)=0.469,r=0.612,r=0.582,r=0.445;P<0.05)。K^(trans)与ER、PR均呈明显负相关(r=-0.526,r=-0.458;P<0.05)。K_(ep)与ER、HER-2均呈明显负相关(r=-0.615,r=-0.526;P<0.05)。DWI检查中,ADC值b=500和ADC值b=1000与肿瘤最大直径、淋巴结转移、远处转移以及组织学分级均呈明显负相关(r_(b=500)=-0.485,r=-0.498,r=-0.487,r=-0.655;rb=1000=-0.562,r=-0.511,r=-0.516,r=-0.597;P<0.05)。结论:DCE-MRI�Objective:To analyze the correlation between dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion-weighted imaging(DWI)and prognostic factors of invasive breast cancer(IBC).Methods:100 female patients with breast cancer admitted to hospital were selected.After routine breast MRI plain scan,all of then underwent DCE-MRI examination and DWI examination.A series of prognostic factors included the maximum diameter of tumor,lymphatic metastasis and the histological grade in IBC patients were analyzed by statistic method.The routine immunohistochemical streptomycin avidin-peroxidase(SP)method was used to detect estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2)and Ki67 antigen(Ki-67)of patients with breast cancer.Pearson linear correlation analysis was used to analyze the correlation of the changes of each factor level.In addition,the volume transfer constant(K^(trans))and rate constant(K_(ep))of contrast agent were determined.Results:There were significant differences in K^(trans) levels of the maximum diameter,lymph node metastasis,distant metastasis,histological grade,and the expressions of ER and PR among different tumors of IBC patients(Z=12.35,Z=1.71,Z=1.83,Z=4.28,Z=6.34,Z=5.86,P<0.05).There were significant differences in the K_(ep) level of the maximum diameter,distant metastasis,histological grade,and the expressions of ER and PR among different tumors(Z=6.81,Z=1.72,Z=6.42,Z=5.68,Z=5.71,P<0.05).There were significant differences in the maximum diameter,lymph node metastasis,distant metastasis,histological grade,and the levels of ADC value b=50 and ADC value b=100 of the ER,PR and HER-2 expressions among different tumors(x^(2)_(b=500)=3.78,x^(2)=4.65,x^(2)=3.65,x^(2)=4.71,x^(2)=6.85,x^(2)=5.81,x^(2)=4.85,x^(2)_(b=100)0=3.28,x^(2)=5.67,x^(2)=5.17,x^(2)=4.92,x^(2)=3.87,x^(2)=3.84,x^(2)=3.19,P<0.05).In DCE-MRI examination,both K^(trans) and K_(ep) were significantly positive correlation with the maximum diameter of tumor,lymph node metast

关 键 词:动态对比增强磁共振成像(DCE-MRI) 弥散加权成像(DWI) 浸润性乳腺癌(IBC) 预后 相关性 

分 类 号:R445.2[医药卫生—影像医学与核医学]

 

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