动态对比增强MRI定量参数及其直方图对乳腺良恶性病变鉴别诊断的价值  

Value of Dynamic Contrast Enhanced MRI Quantitative Parameters and Histogram in Benign and Malignant Breast Lesions

作　　者：王梅[1] 郭浩东 朱建国[1] 李海歌[1] 雍千叶 WANG Mei;GOU Haodong;ZHU Jianguo(Department of Radiology,The Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210011,P.R.China)

机构地区：[1]南京医科大学第二附属医院医学影像科,210011

出　　处：《临床放射学杂志》2023年第2期222-227,共6页Journal of Clinical Radiology

摘　　要：目的验证动态对比增强磁共振成像(DCE-MRI)定量参数在乳腺良恶性病变中的诊断效能,探讨其最佳定量参数直方图分析的诊断价值,比较DCE-MRI定量参数及直方图参数对鉴别乳腺良恶性病变的价值。方法回顾性分析DCE-MRI检查的151例乳腺病变的患者,共166个病灶,参照病理结果将研究对象分为良性组、恶性组。使用图像后处理软件获得病灶动态增强定量参数容积转运常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积分数(V_(e))、血管容积分数(V_(p))值,Kruskal-Wallis H检验比较DCE-MRI定量参数值的组间差异,采用受试者工作特征曲线(ROC)评价各参数鉴别良恶性病变的效能。选择诊断效能最佳的参数作直方图分析,提取14个直方图参数,评价组间参数差异,通过Logistic回归分析筛选出鉴别良恶性乳腺病变的最佳参数,评价其诊断效能。比较常规定量参数与直方图方法的诊断效能。结果乳腺恶性病变K^(trans)、K_(ep)、V_(p)值大于良性病变,恶性组V_(e)值小于良性组,差异均有统计学意义(P<0.01)。K^(trans)、K_(ep)、V_(e)、V_(p)的曲线下面积(AUC)显示K_(ep)对鉴别乳腺良恶性病变效能最佳(AUC=0.905)。Logistic回归分析筛选出K_(ep)直方图对鉴别乳腺良恶性病变的最佳参数:方差(Variance)、第5百分位数(Quantile5)、第95百分位数(Quantile95)。三个直方图参数联合、K_(ep)值及二者联合的诊断效能无统计学差异(P均>0.05)。结论DCE-MRI定量参数(K^(trans)、K_(ep)、V_(e)、V_(p))能有效鉴别乳腺良恶性病变,其中K_(ep)值诊断效能最佳,对K_(ep)的直方图进行探讨分析,证明其有同样高的诊断价值。Objective To verify the diagnostic efficacy of quantitative parameters of dynamic enhanced magnetic resonance imaging(DCE-MRI)in benign and malignant breast lesions,and to study the diagnostic value of histogram analysis of the best quantitative parameters.To compare the value of the quantitative parameters and histogram in differentiating benign and malignant breast lesions.Methods A total of 151 patients with 166 breast lesions who underwent dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)were analyzed retrospectively.According to the pathology,all the lesions were divided into benign group and malignant group.The images were analyzed by post-processing software,the DCE-MRI quantitative parameters of the tumors were obtained,including K^(trans),K_(ep),V_(e)and V_(p).Kruskal-Wallis H test was used to compare the differences of DCE-MRI parameters between benign group and malignant group.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the quantitative parameters in identifying benign and malignant lesions.The quantitative parameters with the best diagnostic efficiency were selected for histogram analysis,and then fourteen histogram parameters were extracted.The differences of histogram parameters between groups were compared,and the parameters for distinguishing benign and malignant breast lesions were selected by Logistic regression analysis.ROC was used to evaluate diagnostic efficiency.Finally,the diagnostic efficiency of conventional quantitative parameters and histogram parameters were compared.Results The value of K^(trans),K_(ep)and V_(p)in malignant group were higher than those of benign group,and the value of V_(e)in malignant group was lower than that in benign group(P<0.01).The area under ROC curve(AUC)showed that K_(ep)was the best in differentiating benign and malignant breast tumors(AUC=0.905).Binary Logistic regression analysis screened out the best parameters of K_(ep)histogram for differentiating benign and malignant breast lesions:variance,

关 键 词：乳腺病变 磁共振成像 动态对比增强 定量参数 直方图 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]