定量DCE-MRI联合IVIM、DKI对三阴性乳腺癌的诊断价值  

The values of quantitative DCE-MRI combined with IVIM and DKI in the diagnosis of triple negative breast cancer

作　　者：金艳[1] 王彦辉[2] 赵庆[1] 李彩霞[1] 赵福香[1] 王唯伟 JIN Yan;WANG Yanhui;ZHAO Qing;LI Caixia;ZHAO Fuxiang;WANG Weiwei(Department of Magnetic Resonance,Second People's Hospital of Jiaozuo,Jiaozuo 454001,China;Department of Magnetic Imaging,Affiliated Hospital of Jining Medical University,Jining 270029,China)

机构地区：[1]河南省焦作市第二人民医院磁共振室,河南焦作454001 [2]济宁医学院附属医院医学影像科,山东济宁272029

出　　处：《医学影像学杂志》2024年第12期73-77,共5页Journal of Medical Imaging

基　　金：山东省中医药科技项目(编号:Q-2022132)。

摘　　要：目的探讨体素内不相干运动(IVIM)、扩散峰度成像(DKI)及动态增强磁共振成像(DCE-MRI)对三阴性乳腺癌(TNBC)及非TNBC的鉴别诊断价值。方法选取经病理证实的乳腺癌患者162例,其中TNBC组46例,非TNBC组116例,患者均行IVIM、DKI及DCE-MRI检查。分析两组间的临床病理资料、常规MRI征象和IVIM、DKI及DCE-MRI模型的诸定量参数。结果TNBC组的病灶不规则形较非TNBC组少见,强化多不均匀,环形强化占比较大,两组间差异有统计学意义(P=0.027,P=0.049)。TNBC组的D、f值及MD、Kep值高于非TNBC组(P<0.05),而TNBC组的MK、Ve值小于非TNBC组差异有统计学意义(P=0.007;P<0.001)。Ve值对于诊断TNBC的AUC为0.820,大于其他定量参数(Z=2.336~3.706,P=0.002~0.020)。DCE-MRI模型的AUC为0.851,大于IVIM(AUC=0.732)及DKI(AUC=0.685)模型(AUC=0.660)(Z=2.408,P=0.016;Z=3.081,P=0.002)。联合模型的AUC为0.900,诊断效能高于单一模型差异有统计学意义(Z=2.294~5.330,P<0.05)。结论IVIM、DKI和DCE-MRI可用于TNBC及非TNBC的鉴别诊断,DCE-MRI模型诊断效能最高,三者联合的鉴别诊断能力优于单一模型。Objective To explore the diagnostic value of multimodal magnetic resonance imaging(IVIM+DKI+DCE-MRI model)for the diagnosis of triple negative breast cancer.Methods A total of 162 cases of breast cancer confirmed by pathology were collected,including 46 cases in the triple negative group and 116 cases in the non-triple negative group.IVIM,DKI and DCE-MRI scanning were performed in all patients.The clinicopathological characteristics and conventional MRI features and the quantitative parameters of IVIM,DKI,and DCE-MRI models were analyzed.Results Irregular lesions in the triple negative group were less common than those in the non-triple negative group(P=0.027).The triple negative group had higher proportion of patients with heterogeneous enhancement and rim enhancement(P=0.049).The D,f and MD,Kep values of the triple negative group were higher than those of the non-triple negative group(P<0.05).The MK and Ve values of the triple negative group were lower than those of the non-triple negative group(P=0.007;P<0.001).The AUC of Ve value was 0.820,which was higher than the other quantitative parameters(Z=2.336~3.706,P=0.002~0.020).The AUC of the DCE-MRI model was 0.851,which was greater than that of the IVIM(AUC=0.732)and DKI model(AUC=0.685),and the difference was statistically significant(Z=2.408,P=0.016;Z=3.081,P=0.002).The AUC of the combining IVIM,DKI and DCE-MRI models was 0.900,the diagnostic performance was higher than the single model(Z=2.294~5.330,P<0.05).Conclusion Multiparametric diffusion-weighted imaging(IVIM+DKI+DCE-MRI)can be used for the diagnosis of triple negative breast cancer,and the DCE-MRI model has the highest diagnostic efficacy.The combination of the three methods is better than a single model.

关 键 词：三阴性乳腺癌 磁共振成像 诊断价值 

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