摘要
目的探讨Extended Tofts模型、Reference模型、Exchange模型三种不同药代动力学模型在诊断乳腺癌中的诊断效能。方法选择2018年6月~2019年10月在我院收治的50例乳腺肿块患者按照病理学诊断结果分为乳腺良性病变组(n=19)、乳腺癌组(n=31)。所有患者在术前接受双侧乳腺DCE-MRI检查,采用Extended Tofts模型、Reference模型、Exchange模型分别计算乳腺肿瘤的定量灌注参数。对比两组患者的各项乳腺肿瘤定量灌注参数,选出具有统计学意义的定量灌注参数,绘制鉴别诊断乳腺癌的ROC曲线,比较各定量灌注参数的AUC、敏感度、特异度和准确度。结果乳腺癌组患者Extended Tofts模型中的Ktrans、Kep、Ve、Vp值均明显大于乳腺良性病变组,乳腺癌组Reference模型中的Ktrans、Kep值明显高于乳腺良性病变组,乳腺癌组患者Exchange模型中的Ve、Vp值均明显高于乳腺良性病变组,差异有统计学意义(P<0.05)。Extended Tofts模型中Ktrans、Kep值以及Reference模型中Ktrans值在鉴别诊断乳腺癌中具有较好的诊断价值,AUC均达到0.8以上,敏感度分别为93.55%、87.10%和83.87%,特异度分别为84.21%、73.68%和73.68%,准确度分别为90.00%、82.00%和80.00%。结论三种药代动力学模型在鉴别诊断乳腺癌上均具有一定的诊断价值,其中Extended Tofts模型中Ktrans、Kep值及Reference模型中Ktrans值在鉴别诊断乳腺癌上的诊断效能相对较高。
Objective To explore the diagnostic efficiency of the three different pharmacokinetic models of Extended Tofts model,Reference model and Exchange model in the diagnosis of breast cancer.Methods A total of 50 patients with breast masses admitted to and treated in our hospital from June 2018 to October 2019 were selected and divided into the benign breast lesion group(n=19)and the breast cancer group(n=31)according to the results of pathological diagnosis.All the patients received DCE-MRI examination of bilateral mammary glands before operations,and the quantitative perfusion parameters of breast tumors were calculated through Extended Tofts model,Reference model and Exchange model respectively.All quantitative perfusion parameters of breast tumors of the two groups were compared,the quantitative perfusion parameters with statistical significance were selected,the ROC curve for the differential diagnosis of breast cancer was drawn,and the AUC,sensitivity,specificity and accuracy of each quantitative perfusion parameter were compared.Results The Ktrans,Kep,Ve and Vp values in the Extended Tofts model of the patients of the breast cancer group were all significantly higher than those of the benign breast lesion group,the Ktrans and Kep values in the Reference model of breast cancer group were significantly higher than those in the benign breast lesion group,and the Ve and Vp values in the Exchange model of the breast cancer group were both significantly higher than those in the benign breast lesion group,with statistically significant differences(P<0.05).The Ktrans and Kep values in the Extended Tofts model and the Ktrans value in the Reference model have good diagnostic value in the differential diagnosis of breast cancer,the AUC was above 0.8 in each case,the sensitivity was 93.55%,87.10%and 83.87%respectively,the specificity was 84.21%,73.68%and 73.68%respectively,and the accuracy was 90.00%,82.00%and 80.00%respectively.Conclusion The three pharmacokinetic models all have certain diagnostic value in the differenti
作者
王小玲
宋坤
杨立铭
徐阿巧
赵娟
WANG Xiaoling;SONG Kun;YANG Liming;XU Aqiao;ZHAO Juan(Department of Radiology,Shaoxing People's Hospital in Zhejiang Province,Shaoxing Hospital,Zhejiang University,Shaoxing312000,China;Department of Radiology,Shaoxing Central Hospital in Zhejiang Province,Shaoxing 312000,China;Department of Pathology,Shaoxing People's Hospital in Zhejiang Province,Shaoxing Hospital,Zhejiang University,Shaoxing312000,China)
出处
《中国现代医生》
2020年第28期125-128,133,F0003,共6页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2018KY829)。
