连续时间随机游走DWI在乳腺病变中的应用及其预测乳腺癌Ki-67表达水平  

The application of a continuous-time random-walk diffusion model in breast lesions and its correlation with Ki-67 expression

作　　者：汪飞 孙宜楠 金燕 章少兰 杨润宇 刘孟潇 余永强[4] 朱娟 WANG Fei;SUN Yi-nan;JIN Yan;ZHANG Shao-lan;YANG Run-yu;LIU Meng-xiao;YU Yong-qiang;ZHU Juan(Department of Radiology,Anqing Medical College Clinical Research Center(Anqing Municipal Hospital),Anqing Anhui 246001,China;Department of Women Health Care,Anqing Yingjiang District Maternal and Child Health Planning Service Center,Anqing Anhui 246003,China;MR Research&Marketing Department,Siemens Healthineers Co.,Ltd.,Shanghai 200126,China;Department of Radiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230032,China)

机构地区：[1]安庆医药高等专科学校临床科研中心(安庆市立医院)医学影像科,安徽安庆246001 [2]安庆市迎江区妇幼保健计划生育服务中心妇保科,安徽安庆246003 [3]西门子医疗系统有限公司MR科研市场部,上海200126 [4]安徽医科大学第一附属医院放射科,安徽合肥230032

出　　处：《中国临床医学影像杂志》2025年第4期229-233,共5页Journal of China Clinic Medical Imaging

基　　金：安徽省教育厅高校科学研究项目(2023AH053433)。

摘　　要：目的:探讨磁共振连续时间随机游走(CTRW)-DWI对乳腺良恶性病变的鉴别诊断价值,并分析CTRW-DWI参数预测乳腺癌Ki-67的表达水平。方法:对114例乳腺病变患者进行CTRW模型(Dm、α和β)和单指数模型DWI评估。应用单因素和多因素Logistic回归对CTRW-DWI参数和ADC值在乳腺良恶性病变鉴别和乳腺癌Ki-67表达水平中进行分析,采用受试者工作特征曲线分析其诊断效能。结果:在单因素分析中,乳腺恶性病变的CTRW参数(Dm、α和β)和ADC值均显著低于良性病变(P<0.05);在多因素分析中,Dm+β联合诊断乳腺恶性病变的曲线下面积值(0.91)最高。在乳腺癌中,Ki-67高表达组的CTRW参数Dm明显低于Ki-67低表达组(P<0.05)。结论:磁共振CTRW-DWI为无创性评估乳腺恶性肿瘤及更好地了解肿瘤组织异质性提供了一种新的方法。Objective:To explore the value of continuous-time random-walk(CTRW)-DWI for the differential diagnosis of benign and malignant breast lesions,and to analyze the correlation between CTRW-DWI parameters and Ki-67 expression in malignant breast lesions.Methods:A total of 114 cases of breast lesions were evaluated with CTRW model(Dm,αandβ)and single index model DWI.Univariate and multivariate Logistic regression were applied to analyze the CTRW-DWI parameters and ADC values in the differentiation of benign and malignant breast lesions and Ki-67 expression.The diagnostic efficacy was analyzed using the receiver-operating characteristic curve.Results:In univariate analysis,the CTRW parameters(Dm,αandβ)and ADC values of malignant breast lesions were significantly lower than those of benign lesions(P<0.05);In multivariate analysis,the combination of Dm andβhad the highest area under curve value(0.91)in diagnosis of benign and malignant breast lesions.In malignant breast lesions,the CTRW parameter Dm in the high Ki-67 expression group was significantly lower than that in the low Ki-67 expression group(P<0.05).Conclusion:CTRW-DWI in MRI provides a new non-invasive method for assessing malignant breast tumors and better understanding the heterogeneity of tumor tissue.

关 键 词：乳腺肿瘤 乳腺疾病 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R655.8[医药卫生—临床医学] R445.2