集成MRI定量参数联合表观扩散系数预测乳腺癌Ki-67表达状态的临床研究  

A clinical study on the prediction of Ki-67 expression status in breast cancer by quantitative parameters combined with apparent diffusion coefficient of synthetic MRI

作　　者：黄越 李锋[3] HUANG Yue;LI Feng(Xiangyang Central Hospital of Wuhan University of Science and Technology,Xiangyang 441021,China;School of Medicine,Wuhan University of Science and Technology,Wuhan 430081,China;Department of Radiology,Xiangyang Central Hospital,Hubei University of Arts and Sciences,Xiangyang 441021,China)

机构地区：[1]武汉科技大学襄阳市中心医院研究生联合培养基地,襄阳441021 [2]武汉科技大学医学部医学院,武汉430081 [3]湖北文理学院附属襄阳市中心医院放射影像科,襄阳441021

出　　处：《磁共振成像》2025年第4期41-47,53,共8页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的 探讨增强前后集成MRI(synthetic MRI,SyMRI)定量参数与乳腺癌细胞增殖核抗原(Ki-67 antigen,Ki-67)表达状态之间的关系,并评估该参数联合表观扩散系数(apparent diffusion coefficient,ADC)在Ki-67表达状态中的预测效能。材料与方法 回顾性收集2023年3月至2024年10月期间,在襄阳市中心医院就诊并确诊为乳腺癌的163例患者的临床与影像资料,这些患者均接受完整的MRI检查,并通过病理学检查证实肿瘤性质。在GE工作站上,获取并记录增强前后SyMRI定量参数值,增强前T1值(T1-Pre)、增强前T2值(T2-Pre)、增强前质子密度值(proton density,PD-Pre)和增强后T1值(T1-Gd)、增强后T2值(T2-Gd)、增强后PD值(PD-Gd),并据此计算各值增强前后弛豫时间相对变化率,记作ΔT1%、ΔT2%和ΔPD%。根据Ki-67表达情况,将收集的患者分为高表达组(≥30%)和低表达组(<30%),采用SPSS 27对数据结果进行统计学分析,以P<0.05表示差异具有统计学意义。定性资料采用卡方检验,定量资料进行柯尔莫戈洛夫-斯米诺夫(Kolmogorov-Smirnov test,K-S)检验正态分布后,采用独立样本t检验或非参数检验比较Ki-67高表达组和低表达组磁共振参数的组间差异,将有意义的变量纳入二元logistic回归分析,将有统计学意义的变量建立联合模型,并利用DeLong检验评估模型对Ki-67表达状态的预测效能。结果 两组在病灶最大直径、ADC值、雌激素受体、孕激素受体、时间-信号强度曲线(time-signal intensity curve,TIC)和采用的治疗方案选择方面差异存在统计学意义(P<0.05);但患者年龄、人类表皮生长因子受体2(human epidermal growth factor receptor,HER-2)、病灶边缘和形态、强化特征、乳腺腺体类型、淋巴结是否转移等因素,两组间差异不具有统计学意义。关于SyMRI定量参数,高、低表达组在T1-Pre、T2-Pre、T1-Gd、T2-Gd、ΔT1%方面差异具有统计学意义(P<0.05);而PD-Pre、PD-Gd、ΔT2%、ΔPD%两组间Objective:To explore the relationship between quantitative parameters of synthetic MRI(SyMRI) before and after enhancement and the expression status of Ki-67 antigen in breast cancer,and to evaluate the predictive efficacy of these parameters combined with apparent diffusion coefficient(ADC) in the expression status of Ki-67.Materials and Methods:The clinical and imaging data of 163 patients diagnosed with breast cancer at Xiangyang Central Hospital from March 2023 to October 2024 were retrospectively collected.All patients underwent complete MRI examinations and their tumor natures were confirmed by pathological examination.On the GE workstation,quantitative parameter values of SyMRI before and after enhancement were obtained and recorded,including pre-enhancement T1 value(T1-Pre),pre-enhancement T2 value(T2-Pre),pre-enhancement proton density value(PD-Pre),post-enhancement T1 value(T1-Gd),post-enhancement T2 value(T2-Gd),and post-enhancement PD value(PD-Gd).The relative change rates of relaxation time before and after enhancement were calculated and recorded as ΔT1%,ΔT2%,and ΔPD%.According to the expression status of Ki-67,the collected patients were divided into high expression group(≥ 30%) and low expression group(< 30%).Statistical analysis of the data was performed using SPSS 27 software,with P < 0.05 indicating statistical significance.Qualitative data were analyzed using the chi-square test,and quantitative data were analyzed using the Kolmogorov-Smirnov(K-S) test for normal distribution.Independent sample t-test or non-parametric Mann-Whitney U test was used to compare the differences in MRI parameters between the high and low expression groups of Ki-67.Significant variables were included in binary logistic regression analysis,and the DeLong test was used to evaluate the predictive efficacy of the model for the expression status of Ki-67.Results:There were statistically significant differences between the two groups in terms of maximum lesion diameter,ADC value,estrogen receptor,progesterone recepto

关 键 词：磁共振成像 乳腺癌 集成磁共振成像 细胞增殖核抗原 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]