磁共振虚拟弹性成像和体素不相干运动成像评估乳腺良、恶性病变:与超声弹性成像的对比研究  

MRI-Based Virtual Elastography and Intravoxel Incoherent Motion Imaging for Assessing Benign and Malignant Breast Lesions:A Comparative Study with Ultrasound Elastography

作　　者：张梦 王雪佳[1] 郭永丽 段金辉 闫瑞芳[1] 韩东明[1] ZHANG Meng;WANG Xuejia;GUO Yongli(Department of Magnetic Resonance,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henana Province 453100,P.R.China)

机构地区：[1]新乡医学院第一附属医院磁共振科,卫辉453100 [2]新乡医学院第一附属医院超声科,卫辉453100

出　　处：《临床放射学杂志》2025年第4期618-622,共5页Journal of Clinical Radiology

基　　金：河南省医学科技公关计划联合共建项目(编号:LHGJ20230528、2018020367);新乡医学院第一附属医院青年培育基金项目(编号:QN-2022-B11)。

摘　　要：目的探索磁共振虚拟弹性成像(vMRE)和体素不相干运动成像(IVIM)鉴别乳腺良、恶性病变的价值。方法分析30例乳腺良性病变和40例乳腺恶性病变的超声弹性成像(USE)、vMRE和IVIM影像资料,测量病灶的超声剪切模量(μUSE)、扩散剪切模量(μDiff)、真性扩散系数(D)、假性扩散系数(D^(*))和灌注分数(f)值并进行组间对比。Pearson相关和逻辑回归分析分别被用于相关性分析和多参数联合诊断;受试者工作特征曲线下面积(AUC)和DeLong检验分别被用于诊断性能的评估与对比。结果乳腺良性病变组的D值大于恶性病变组,μUSE、μDiff和f值小于恶性病变组(均P<0.001),两组病变间D^(*)值无显著差异。μUSE与μDiff和f分别呈中度和轻度正相关(r=0.605、0.273,P<0.001、P=0.022),与D呈中度负相关(r=-0.403,P<0.001),与D^(*)无明显相关性。AUC和DeLong检验显示,基于vMRE和IVIM的MRI多参数联合(μDiff+D+f)鉴别乳腺良、恶性病变的诊断性能可达0.916(95%CI:0.825~0.969;敏感性80.00%;特异性90.00%),显著高于USE(AUC=0.802,Z=2.043,P=0.041)。结论USE、vMRE和IVIM均可用于鉴别乳腺良、恶性病变,但基于vMRE和IVIM的MRI多参数联合能够较USE具有更高的诊断性能。Objective To explore the value of magnetic resonance(MRI)virtual elastography(vMRE)and intravoxel incoherent motion(IVIM)imaging in identifying benign and malignant breast lesions.Methods Ultrasound elastography(USE),vMRE and IVIM imaging data of 30 benign and 40 malignant breast lesions were analyzed,and ultrasound shear modulus(μUSE),diffusion shear modulus(μDiff),true diffusion coefficient(D),pseudo-diffusion coefficient(D^(*)),and perfusion fraction(f)values of the lesions were measured and compared between groups.Pearson correlation and logistic regression analyses were used for correlation analyses and multiparameter combined diagnosis,respectively;the area under the receiver operating characteristic curve(AUC)and the DeLong's test were used for assessment and comparison of diagnostic performance,respectively.Results D values were greater in the benign breast lesion group than in the malignant lesion group,andμUSE,μDiff,and f values were less than those in the malignant lesion group(all P<0.001),and there was no significant difference in the D^(*)values between the two groups of lesions.μUSE was moderately and mildly positively correlated withμDiff and D,respectively(r=0.605,0.273,P<0.001,=0.022),and was moderately negatively correlated with D(r=-0.403,P<0.001)and with no significant correlation with D^(*).The AUC and DeLong's test showed that the diagnostic performance of combined vMRE and IVIM-based MRI multiparameter(μDiff+D+f)to identify benign and malignant breast lesions was up to 0.916(95%CI:0.825-0.969;sensitivity:80.00%;specificity:90.00%),which was significantly higher than the USE(AUC=0.802,Z=2.043,P=0.041).Conclusion USE,vMRE and IVIM can all be used to identify benign and malignant breast lesions,but combined vMRE-and IVIM-based MRI multiparameter can have higher diagnostic performance than USE.

关 键 词：磁共振虚拟弹性成像 体素不相干运动成像 超声弹性成像 乳腺良恶性病变 

分 类 号：R44[医药卫生—诊断学]