摘要
目的探讨扩散峰度成像(DKI)联合定量动态增强磁共振成像(DCE-MRI)预测乳腺癌腋窝淋巴结转移的价值。方法回顾性分析2019年10月至2022年9月济宁医学院附属医院经病理证实的150例乳腺癌患者,68例有腋窝淋巴结(ALN)转移,82例无ALN转移,术前乳腺病灶均行DKI及DCE-MRI检查。分析两组间临床病例资料、常规MRI征象、DKI和DCE-MRI参数[扩散峰度值(MK)、平均扩散率(MD)、容量转移常数(K^(trans))、血管外细胞外间隙容积比(Ve)和速率常数(Kep)];并运用受试者工作特征(ROC)曲线分析各定量参数对乳腺癌ALN转移的诊断效能。结果ALN转移组病灶边缘模糊的比例高于无ALN转移组(P=0.032);ALN转移组瘤内不均匀强化、环形强化占比较大(P=0.018)。ALN转移组MD值低于无ALN转移组(P=0.021);MK值及K^(trans)、Kep值高于无ALN转移组(均P<0.01)。DCE-MRI模型的K^(trans)值对乳腺癌ALN转移的诊断效能最高,ROC曲线下面积(AUC)为0.831;DCE-MRI模型的AUC为0.833,高于DKI模型(AUC=0.733),差异具有统计学意义(Z=2.208;P=0.027)。而DCE-MRI及DKI模型的AUC均高于常规MRI模型(Z=3.184,P=0.002;Z=1.917,P=0.046)。将DKI、DCE-MRI模型联合后诊断乳腺癌ALN转移的灵敏度及准确度均高于单一模型。结论DKI和DCE-MRI模型可用于预测乳腺癌腋窝淋巴结转移,其中DCE-MRI模型的K^(trans)值诊断效能最高,DKI联合DCE-MRI模型对乳腺癌腋窝淋巴结转移的预测能力优于单一模型。
ObjectiveTo investigate the value of diffusion kurtosis imaging(DKI)combined with quantitative dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in predicting axillary lymph node metastasis in breast cancer.MethodsA total of 150 cases of breast cancer confirmed by pathology in the Affiliated Hospital of Jining Medical University were retrospectively analyzed.68 cases had axillary lymph node(ALN)metastasis and 82 cases had no ALN metastasis.All breast lesions were examined by DKI and DCE-MRI before operation.We analyzed clinical case data,routine MRI features,DKI,and DCE-MRI parameters between two groups,including diffusion kurtosis(MK),mean diffusion rate(MD),volume transfer constant(K^(trans)),extravascular volume fraction(Ve),and rate constant(Kep);The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of quantitative parameters for ALN metastasis of breast cancer.ResultsThe proportion of lesions with blurred edges in the metastatic group was higher than that in the non ALN metastatic group(P=0.032);The proportion of uneven and circular enhancement within the ALN metastasis group was relatively high(P=0.018).The MD value of the ALN transfer group was lower than that of the group without ALN transfer(P=0.021);The MK value,K^(trans)value,and Kep value were higher than those in the group without ALN metastasis(all P<0.01).The K^(trans)value of DCE-MRI model was the most effective in diagnosing ALN metastasis of breast cancer,and the area under the ROC curve(AUC)was 0.831;The AUC of DCE-MRI model was 0.833,which was higher than that of DKI model(AUC=0.733),and the difference was statistically significant(Z=2.208;P=0.027).The AUC of DCE-MRI and DKI models were higher than that of conventional MRI models(Z=3.184,P=0.002;Z=1.917,P=0.046).The sensitivity and accuracy of combined DKI and DCE-MRI models in the diagnosis of ALN metastasis in breast cancer were higher than those of single model.ConclusionsDKI and DCE-MRI models can be used to predict axillary lymph node metas
作者
安丽华
冯海霞
孙圣峰
李静
单广震
胡喜斌
王唯伟
An Lihua;Feng Haixia;Sun Shengfeng;Li Jing;Shan Guangzhen;Hu Xibin;Wang Weiwei(Department of Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,China)
出处
《中国医师杂志》
CAS
2024年第8期1180-1185,共6页
Journal of Chinese Physician
基金
山东省中医药科技项目(Q-2022132)
济宁医学院附属医院医学英才培养计划项目(2022-yxyc-010)。
关键词
乳腺肿瘤
淋巴转移
扩散峰度成像
动态增强磁共振成像
Breast neoplasms
Lymphatic metastasis
Diffusion kurtosis imaging
Dynamic contrast enhancement imaging
