基于多参数磁共振成像对三阴性乳腺癌的诊断价值  

Diagnostic Value of Multi Parameter Magnetic Resonance Imaging in Triple Negative Breast Cancer

作　　者：王正通 王唯伟 邵凯 陈月芹[1] 史志涛[1] 于昊 陈霖 孙占国[1] WANG Zheng-tong;WANG Wei-wei;SHAO Kai;CHEN Yue-qin;SHI Zhi-tao;YU Hao;CHEN Lin;SUN Zhan-guo(Department of Radiology,Affiliated Hospital of Jining Medical University,Jining 272100,Shandong Province,China)

机构地区：[1]济宁医学院附属医院医学影像科,山东济宁272100

出　　处：《中国CT和MRI杂志》2024年第12期84-87,共4页Chinese Journal of CT and MRI

基　　金：山东省中医药科技项目(Q-2022132);济宁市重点研发计划项目(2023YXNS095、2023YXNS133)。

摘　　要：目的探讨MRI多参数及其联合对TNBC的诊断价值。方法回顾性分析经病理证实的乳腺癌患者160例,其中TNBC45例,非TNBC115例。所有患者均行MRI检查并进行分析。结果TNBC组的肿瘤形状多表现为类圆形,边缘光滑,增强多为环形强化,差异均有统计学意义(P<0.05);TNBC组的D值、f值及MD值高于非TNBC组,而MK值低于非TNBC组,以上差异均有统计学差异(P<0.05);常规MRI模型AUC为0.816,大于形状、边缘及强化方式单一特征的AUC(P均<0.001);IVIM+DKI模型AUC为0.870,大于单一模型的AUC,且与DKI模型差异具有统计学意义(P<0.001);此外,IVIM+DKI模型诊断效能均高于单一参数D、f、MD及MK(P均<0.001);联合模型的AUC为0.971,诊断效能高于单一模型的AUC(P均<0.001)。结论基于多参数MRI模型可用于TNBC的诊断,而联合模型的诊断效能均优于单一模型,有利于TNBC患者的个性化诊疗和预后评估。Objective To invstigate the diagnostic value of MRI multi parameters and their combination in TNBC.Methods A retrospective analysis was made on 160 cases of breast cancer confirmed by pathology,including 45 cases of TNBC and 115 cases of non TNBC.All patients underwent MRI examination and analysis.Results In the TNBC group,the tumor shape was mostly circular,the edge was smooth,and the enhancement was mostly circular,the differences were statistically significant(P<0.05);the D value,f value,and MD value of the TNBC group were higher than those of the non TNBC group,while the MK value was lower than that of the non TNBC group,with statistical differences(P<0.05);the AUC of conventional MRI model was 0.816,which was larger than that of single features of shape,edge and enhancement mode(P<0.001);the AUC of IVIM+DKI model was 0.870,which was larger than that of single model,and the difference was statistically significant(P<0.001);in addition,the diagnostic efficiency of IVIM+DKI model was higher than that of single parameters D,f,MD and MK(P<0.001);the AUC of the combined model was 0.971,and the diagnostic efficiency was higher than that of the single model(P<0.001).Conclusion The multi-parameter MRI model can be used for the diagnosis of TNBC,and the combined model has better diagnostic efficacy than the single model,which is conducive to the personalized diagnosis and treatment and prognosis assessment of TNBC patients.

关 键 词：三阴性乳腺癌 常规MRI 体素内不相干运动 扩散峰度成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]