摘要
目的探究动态对比增强和扩散加权成像的多参数MRI模型预测乳腺癌肿瘤血管新生的价值。方法回顾性选取113例乳腺癌患者,根据病理学活检结果将患者分为浸润性导管癌组(A组,n=36)、导管内癌组(B组,n=44)、良性病变组(C组,n=33)。所有受试者均通过动态对比增强(DCE-MRI)和扩散加权成像(DWI)的多参数MRI检查,对比分析3组患者ADC值、血管通透性的各定量参数,微血管密度(MVD)计数和血管内皮生长因子(VEGF)阳性表达率;分析MRI各参数与MVD及VEGF阳性表达率相关性和不同检验方法的诊断效能。结果3组患者的ADC值、Ktrans和Kep、MVD计数和VEGF阳性表达率比较,A组显著高于B组和C组,C组最小,差异均有统计学意义(P<0.05)。并且,MVD计数和VEGF阳性表达率与ADC值呈负相关(P<0.05);MVD计数和VEGF阳性表达率与Ve的相关性不显著(P>0.05);MVD计数和VEGF阳性表达率与Ktrans和Kep均呈显著的正相关(P<0.05)。DWI和DCE-MRI二者联合对预测乳腺癌肿瘤血管新生的灵敏度、特异度、阳性预测值、阴性预测值和诊断准确率均显著高于仅采用单一方法,差异均有统计学意义(P<0.05)。结论动态对比增强和扩散加权成像的多参数MRI模型可有效预测乳腺癌肿瘤血管新生,能够为后续疾病的治疗及预后提供重要参考,值得推广使用。
Objective To investigate the value of dynamic contrast enhancement and diffusion-weighted multi-parameter MRI model in predicting angiogenesis of breast cancer tumors.Methods A total of 113 breast cancer patients were selected and divided into invasive ductal carcinoma group(group A,n=36),intraductal carcinoma group(group B,n=44)and benign lesion group(group C,n=33)according to pathological biopsy results.All subjects underwent Dynamic contrast-enhanced(DCE-MRI)and Diffusion weighted imaging(DWI)multi-parameter MRI examinations.ADC value,quantitative parameters of vascular permeability,microvascular density(MVD)count and positive expression rate of vascular endothelial growth factor(VEGF)were compared and analyzed in the three groups.The correlation between MRI parameters and the positive expression rate of MVD and VEGF and the diagnostic efficacy of different test methods were analyzed.Results Comparison of ADC value,Ktrans and Kep,MVD count and VEGF positive expression rate among the three groups showed that group A was significantly higher than group B and group C,and group C was the least,the differences were statistically significant(P<0.05).In addition,MVD count and VEGF positive expression rate were negatively correlated with ADC values,and there was no significant correlation between MVD count and VEGF positive expression rate and Ve(P>0.05).MVD count and VEGF positive expression rate were significantly positively correlated with Ktrans and Kep(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of combined DWI and DCE-MRI in predicting angiogenesis of breast cancer were significantly higher than those of single method,the differences were statistically significant(P<0.05).Conclusion Multi-parameter MRI model of dynamic contrast enhancement and diffusion weighted imaging can effectively predict tumor angiogenesis of breast cancer,which can provide important reference for the treatment and prognosis of subsequent diseases,and is worthy of populari
作者
马永刚
张堃
黄斌
万涛
赵志友
MA Yong-gang;ZHANG Kun;HUANG Bin(Department of Medical Imaging,3201 Hospital,Hanzhong Shaanxi 723000,China;Department of Medical Imaging,Xi'an Chang'an Hospital,Xi'an Shaanxi 710016,China)
出处
《临床和实验医学杂志》
2022年第4期443-446,共4页
Journal of Clinical and Experimental Medicine
基金
陕西省社会发展科技攻关项目(编号:2016SF-199)。
关键词
动态对比增强
扩散加权成像
多参数MRI模型
乳腺癌肿瘤血管新生
Dynamic contrast enhancement
Diffusion weighted imaging
Multi-parameter MRI model
Breast cancer tumor angiogenesis
