摘要
目的探讨合成磁共振成像(syMRI)技术在鉴别乳腺病变良恶性及预测乳腺癌淋巴结转移中的应用价值。方法搜集行syMRI检查并且有病理结果的75例乳腺肿块患者(共77个乳腺病灶),所有受试者取病理活检前均行syMRI多对比度定量图谱磁共振成像(MAGiC)序列平扫及增强扫描,比较乳腺肿块经syMRI后处理软件测量的增强前的T_(1)、T_(2)、质子密度(PD)值(T_(1)-pre、T_(2)-pre、PD-pre)以及增强后的T_(1)、T_(2)、PD值(T_(1)-post、T_(2)-post、PD-post),并计算增强前后的相对变化率(ΔT_(1)%、ΔT_(2)%、ΔPD%)。根据病理结果将患者分为良性组、恶性组,恶性病变中又分为淋巴结转移组和淋巴结未转移组,采用独立样本t检验和Wilcoxon秩和检验,分析上述syMRI定量值在各组间的差异是否具有统计学意义(P<0.05),并与病灶动态对比增强磁共振成像(DCE-MRI)上的表现特征[形态、边缘、内部强化情况、时间-信号强度曲线(TIC)]以及表观扩散系数(ADC)进行比较,将有统计学意义的参数纳入二元Logstic回归分析不同预测模型的诊断效能。结果良、恶性组别间syMRI的T_(1)-post、ADC、DCE-MRI的形态、边缘、TIC差异具有统计学意义(P<0.05),DCE-MRI+ADC模型的诊断效能最高[曲线下面积(AUC)为0.958],其次是DCE-MRI+ADC+syMRI模型(AUC为0.957),此外,发现ADC+syMRI模型的效能高于ADC模型(AUC分别为0.928、0.915)。恶性病变中,淋巴结转移组与淋巴结未转移组syMRI的PD-pre和PD-post、DCE-MRI的边缘差异具有统计学意义(P<0.05),ADC值差异无统计学意义(P>0.05),syMRI模型诊断效能优于DCE-MRI(AUC分别为0.693、0.670),syMRI+DCE-MRI的联合模型诊断效能最高(AUC为0.798)。结论合成MRI定量测量的T_(1)-post可作为鉴别乳腺病变良恶性的辅助手段,单独应用时诊断效能低于ADC、DCE-MRI,但其与ADC联合应用可提高ADC的诊断效能。PD-pre、PD-post一定程度上可预测乳腺癌腋窝淋巴结转移,其预测
Objective To explore the application value of synthetic MRI(syMRI)in the differential diagnosis of denign and malignant breast lesions and prognosis lymph node metastasis of breast cancer.Methods A total of 75 patients(77 breast lesions)with pathologically confirmed which underwent syMRI examination were included in the study.All subjects underwent plain scan and enhanced scan of syMRI before pathological biopsy.The T_(1),T_(2),PD values of breast lesions pre-contrast and post-contrast injection(T_(1)-pre,T_(2)-pre,and PD-pre;T_(1)-post,T_(2)-post,and PD-post)were estimated from syMRI data by using syMRI post-processing software.The relative change rate was calculated(ΔT_(1)%,ΔT_(2)%,ΔPD%).According to the pathological results,lesions were divided into the benign lesions group,malignant lesion with lymph node metastasis group and malignant lesion without lymph node metastasis group.Independent sample t-test and Wilcoxon rank-sum test were used to analyze whether the data were significantly different(P<0.05),and comparing with the performance characteristics of dynamic contrast-enhanced imaging MRI(DCE-MRI)(morphology,edge,internal reinforcement,time signal intensity curve)and apparent diffusion coefficient(ADC),and had a statistically significant parameters into binary logstic regression analysis,compare different diagnostic performance of prediction model.Results There were significant differences in T_(1)-post of syMRI,ADC and the morphology,edge and time signal intensity curve of DCE-MRI between benign and malignant groups(P<0.05).The diagnosis efficiency of DCE-MRI+ADC model is highest(AUC was 0.958),followed by DCE-MRI+ADC+syMRI model(AUC was 0.957),in addition,our study found that the ADC+syMRI model efficiency is higher than the ADC model(AUC were 0.928,0.915,respectively).There were significant differences in PD-pre and PD-post of syMRI and the edge of DCE-MRI between lymph node metastasis group and the no-lymph node metastasis group(P<0.05),and there was no statistically significant difference of ADC
作者
余雪燕
周智鹏
童秋云
覃宝仪
王玲廷
YU Xueyan;ZHOU Zhipeng;TONG Qiuyun(Department of Radiology,The Affiliated Hospital of Guilin Medical College,Guilin,Guangxi Zhuang Autonomous Region 541001,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第2期244-251,共8页
Journal of Clinical Radiology
基金
桂林市科学研究与技术开发计划项目(编号:20190202-2)。
