摘要
目的探讨动态MRI灌注定量分析在非肿块强化(NME)乳腺病变诊断中的应用价值。方法回顾性分析2021年1月~12月我院收治并经病理证实的56例NME乳腺病变的临床和MRI影像资料,共56个病灶。所有患者术前均接受DCE-MRI检查。采用独立样本t检验和Mann-Whitney U检验对比各项MRI影像特征的组间差异,采用受试者工作特征(ROC)曲线评价各项参数的诊断效能。结果本组56个NME病灶,穿刺或术后病理结果提示良性病灶33个,恶性病灶23个。良恶性病灶的半定量血流动力学参数早期强化率(EER)(%,181.243±69.163比235.614±49.946)差异具有统计学意义(P≤0.05),晚期强化率(LER)(%,185.071±40.842比197.409±35.261)差异无统计学意义(P=0.247);灌注特征速率常数(Kep)值(0.732±0.326比1.606±0.671)和容量转移常数(Ktrans)值(0.626±0.387比1.380±0.645)、早期强化曲线下面积(IAUGC)(0.356±0.317比0.651±0.263)、对比增强比(CER)值(2.270±0.498比3.026±0.872)、最大增强斜率(MSI)[0.023(0.013,0.034)比0.045(0.033,0.087)]差异均有统计学意义。ROC曲线分析显示,EER的诊断效能优于LER(74.4%比63.5%);定量灌注分析对良恶性的诊断效能优于半定量参数(Kep、Ktrans、MSI诊断准确度分别为90.3%、84.7%、86.1%)。结论DCE-MRI定量灌注分析技术对于NME乳腺病变良恶性的鉴别诊断具有重要价值。
Objective To explore the value of dynamic contrast-enhanced(DCE)-MRI perfusion technique in distinguishing non-mass enhanced(NME)breast pathologies.Methods The clinical records and DCE-MRI of 56 women with NME breast lesions between January 2021 and December 2021 were retrospectively analyzed.Using pathological results as the reference standard,all lesions were divided into benign and malignant groups.The perfusion parameters and hemodynamic features between the two groups were compared using independent samples t-test and Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of MRI parameters.Results The 56 NME lesions included 33 benign and 23 malignant lesions.The early enhancement ratio(EER)was significantly higher(P<0.05)in malignancy(235.615±49.946)than that of benign lesions(181.243±69.163)whereas the late enhancement ratio(LER)was not significantly higher(P=0.247)in malignancy(197.409±35.261)than benign lesions(184.071±40.842).The DCE-MRI parameters in malignancy including the rate constant(Kep,1.606±0.671),volume transfer constant(Ktrans,1.380±0.645),initial area under the gadolinium curve(0.651±0.263),contrast enhancement ratio(3.026±0.872),maximum slope increase(MSI,0.045)were all significantly higher(P<0.05)than those of benign lesions(0.732±0.326,0.626±0.387,0.356±0.317,2.270±0.498,0.023).ROC curve analysis showed that the semi-quantitative EER had better diagnostic performance(74.4%)than that of LER(63.5%).The quantitative parameters also had better diagnostic performance than semi-quantitative parameters with accuracy of 90.3%for Kep,84.7%for Ktrans,and 86.1%for MSI.Conclusion Quantitative perfusion parameters of DCE-MRI have excellent diagnostic performance and can help differentiating benign from malignant NME breast lesions.
作者
赵霞
李秉营
时光喜
邹瑞琪
王宁
ZHAO Xia;LI Bing-ying;SHI Guang-xi;ZOU Rui-qi;WANG Ning(Department of Radiology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong 250014,China)
出处
《影像诊断与介入放射学》
2022年第6期440-445,共6页
Diagnostic Imaging & Interventional Radiology
基金
山东省卫健委医药卫生科技发展计划项目(202104080463)。
关键词
乳腺病变
非肿块强化
动态对比增强
诊断效能
Non-mass enhanced breast lesion
Dynamic contrast enhancement
Benign and malignant
Diagnostic performance
