MRI-DWI-IVIM多参数成像对浸润性乳腺癌新辅助化疗后浸润淋巴细胞水平的预测价值  

The predictive value of MRI-DWI-IVIM multiparameter imaging in tumor infiltrating lymphocyte levels after neoadjuvant chemotherapy for invasive breast cancer

作　　者：边桂风 李晓东[1] 贺松[2] 张斌[1] 李娇娇[1] BIAN Guifeng;LI Xiaodong;HE Song;ZHANG Bin;LI Jiaojiao(Department of Nuclear Magnetic Resonance,the First Affiliated Hospital of Hebei Northern University,Zhangjiakou,Hebei 075000,China;不详)

机构地区：[1]河北北方学院附属第一医院核磁科,河北张家口075000 [2]河北北方学院附属第一医院放射科

出　　处：《中华全科医学》2024年第10期1746-1749,共4页Chinese Journal of General Practice

基　　金：河北省医学科学研究课题(20210136)。

摘　　要：目的 探究浸润性乳腺癌新辅助化疗中采用磁共振(MRI)-扩散加权成像(DWI)-体素内不相干运动(IVIM)多参数成像对患者治疗后浸润淋巴细胞(TILs)水平的预测价值。方法 选择2021年12月-2022年12月河北北方学院附属第一医院收治的140例浸润性乳腺癌患者作为研究对象,均行MRI-DWI-IVIM检查,患者给予新辅助化疗,治疗后评估TILs。分析MRI-DWI-IVIM多参数成像对TILs水平的预测价值。结果 治疗后患者TILs阳性率(80.71%)显著高于治疗前(63.57%,χ^(2)=10.236,P<0.05);TILs阳性与TILs阴性患者边界、T2WI信号、DWI信号比较差异均有统计学意义(P<0.05);TILs阳性患者伪扩散系数(D*)低于TILs阴性,而单纯扩散系数(D)、微血管内容量分数(f)等参数高于TILs阴性(P<0.05);ROC曲线显示,边界、T2WI信号、DWI信号、D*、D、f预测TILs水平的AUC分别为0.640、0.610、0.640、0.866、0.720、0.674,各指标联合预测的AUC为0.948。结论 浸润性乳腺癌新辅助化疗后TILs水平上升,采用MRI-DWI-IVIM多参数成像可以评估患者化疗后TILs水平,各指标联合可以提高对于TILs水平的预测价值。Objective To investigate the potential of magnetic resonance imaging(MRI)with diffusion-weighted imaging(DWI)and intravoxel incoherence motion(IVIM)multiparameter imaging in predicting tumour infiltrating lymphocyte(TILs)levels in patients with invasive breast cancer who have undergone neoadjuvant chemotherapy.Methods A total of 140 patients with invasive breast cancer admitted to the hospital between December 2021 and December 2022 were se-lected as the study subjects.All patients underwent an MRI-DWI-IVIM examination,received neoadjuvant chemothera-py,and had their TILs evaluated after treatment.The utility of MRI-DWI-IVIM multiparameter imaging in predicting TIL levels was evaluated.Results The positive rate of TILs after treatment(80.71%)was significantly higher than that be-fore treatment(63.57%,χ^(2)=10.236,P<0.05).Furthermore,there was a statistically significant difference in the boundary,T2WI signal and DWI signal between TILs positive and TILs negative patients(P<0.05).The pseudo-diffu-sion coefficient(D*)of TILs-positive patients was observed to be lower than that of TILs-negative patients,while the simple diffusion coefficient(D)and microvascular volume fraction(f)were found to be higher than those of TILs-nega-tive patients(P<0.05).Receiver operating characteristic curves demonstrated that the area under the curve(AUC)pre-dicted by the boundary,T2WI signal,DWI signal,D*,D and f on TILs were 0.640,0.610,0.640,0.866,0.720 and 0.674,respectively.Furthermore,the combined AUC of all indicators was 0.948.Conclusion The level of TILs was observed to increase following the administration of neoadjuvant chemotherapy for invasive breast cancer.Multiparam-eter imaging by MRI-DWI-IVIM can be used to evaluate the level of TILs after chemotherapy.Furthermore,the combina-tion of all indicators can improve the predictive value of the TILs level.

关 键 词：浸润性乳腺癌 新辅助化疗 浸润性淋巴细胞 磁共振 扩散加权成像 体素内不相干运动 预测价值 

分 类 号：R445[医药卫生—影像医学与核医学]