DCE-MRI动力学异质性分析对乳腺肿瘤的临床价值  

Clinical value of DCE-MRI dynamic heterogeneity analysis in breast tumors

作　　者：刘光竹 何永胜[2] 戚轩 杨宏楷[2] LIU Guangzhu;HE Yongsheng;Qi Xuan;YANG Hongkai(Ma'anshan Clinical College,Anhui Medical University,Ma'anshan,Anhui 243000,China;Department of Imaging,Ma'anshan People's Hospital,Ma'anshan,Anhui 243000,China;The Fifth Clinical Medical College of Anhui Medical University,Hefei,Anhui 230000,China)

机构地区：[1]安徽医科大学马鞍山临床学院,安徽马鞍山243000 [2]马鞍山市人民医院影像科,安徽马鞍山243000 [3]安徽医科大学第五临床医学院,安徽合肥230000

出　　处：《影像研究与医学应用》2025年第4期13-18,共6页Journal of Imaging Research and Medical Applications

基　　金：马鞍山市科技计划项目(YL-2022-5);2023年安徽医科大学校科研基金项目(2023xkj122)。

摘　　要：目的:提取DCE-MRI动力学异质性参数进行定量分析,探究其在乳腺肿瘤良恶性及不同分子分型的乳腺恶性肿瘤中的临床价值。方法:收集2019年12月—2023年9月马鞍山市人民医院收治的206例女性乳腺肿瘤患者的DCE-MRI病例信息(均有病理结果),根据肿瘤性质分为良性组44例、恶性组162例,其中恶性组又分为Luminal组109例及非Luminal组53例。纳入病例均未经临床干预治疗且术前进行条件相同的MRI检查后,经勾画后得到每个肿瘤三维体积(VOI),提取每个病例的动力学异质性参数并计算肿瘤的动力学异质性,分析基于DCE-MRI动力学异质性分析在乳腺肿瘤中的临床价值。结果:恶性组患者的年龄、高DWI信号表达占比、低T_(2)WI信号表达占比、极少BEP占比均高于良性组,差异有统计学意义(P<0.05)。恶性患者的Plateau、Heterogeneity高于良性患者,差异有统计学意义(P<0.05)。Luminal组与非Luminal组的Ki-67值、T_(2)WI信号比较,差异有统计学意义(P<0.05)。Luminal组与非Luminal组的Peak、Heterogeneity比较,差异有统计学意义(P<0.05)。结论:DCE-MRI动力学异质性参数对乳腺肿瘤良恶性及不同分子分型的乳腺恶性肿瘤具有一定的临床价值,可以为临床决策提供参考依据。Objective To extract and quantitatively analyze dynamic heterogeneity parameters from dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and explore their clinical value in differentiating benign from malignant breast tumors as well as in different molecular subtypes of malignant breast tumors.Methods DCE-MRI case information from 206 female breast cancer patients admitted to Ma'anshan People's Hospital from December 2019 to September 2023(all with pathological results)were collected.The patients were divided into a benign group(n=44)and a malignant group(n=162),with the latter further subdivided into a Luminal group(n=109)and a non-Luminal group(n=53).All included cases underwent MRI under the same conditions without prior clinical intervention.After delineation,the three-dimensional volume of interest(VOI)for each tumor was obtained.Dynamic heterogeneity parameters were extracted for each case to calculate the tumor's dynamic heterogeneity,and the clinical value of DCE-MRI-based dynamic heterogeneity analysis in breast tumors was assessed.Results The malignant group had a higher proportion of patients at an older age,high DWI signal expression,low T_(2)WI signal expression,and very few blood-oxygen-level-dependent(BOLD)effect-positive(BEP)cases compared to the benign group(P<0.05).Malignant patients had higher Plateau and Heterogeneity values than benign patients,with statistically significant differences(P<0.05).The Luminal group differed significantly from the non-Luminal group in Ki-67 values and T_(2)WI signal expression(P<0.05).Additionally,there were statistically significant differences in Peak and Heterogeneity between the Luminal and non-Luminal groups(P<0.05).Conclusion DCE-MRI dynamic heterogeneity parameters demonstrate certain clinical value in differentiating benign from malignant breast tumors and in identifying different molecular subtypes of malignant breast tumors,providing a reference for clinical decision-making.

关 键 词：乳腺肿瘤 磁共振成像 动力学异质性 DCE-MRI 动力学 异质性 

分 类 号：R445.2[医药卫生—影像医学与核医学]