目的探讨能谱CT曲线在判断乳腺浸润性导管癌(IDC)分化程度中的价值。方法回顾性分析经手术病理证实并术前行能谱CT扫描的54例IDC患者的资料,分为高分化组(病理Ⅰ、Ⅱ级)44例、低分化组(病理Ⅲ级)10例,测量并分别比较动脉期和静脉期两组...目的探讨能谱CT曲线在判断乳腺浸润性导管癌(IDC)分化程度中的价值。方法回顾性分析经手术病理证实并术前行能谱CT扫描的54例IDC患者的资料,分为高分化组(病理Ⅰ、Ⅱ级)44例、低分化组(病理Ⅲ级)10例,测量并分别比较动脉期和静脉期两组的能谱曲线(40~100 keV)的规律、差异。采用受试者工作特征曲线(ROC)分别分析比较动、静脉期能谱曲线斜率对IDC分化程度的诊断效能。结果在40~100 ke V,低分化组能谱曲线斜率高于高分化组能谱曲线斜率,差异具有统计学意义(P<0.05);ROC曲线显示:动脉期高-低分化组以斜率k=1.47作为诊断阈值,曲面下面积(AUC)为0.83,敏感度为68.09%,特异度为86.67%;静脉期高-低分化组以斜率k=1.74作为诊断阈值,AUC为0.78,敏感度为91.49%,特异度为58.33%。结论IDC的能谱曲线斜率可于术前提示其病理组织分化程度。展开更多
Background： Blood oxygenation level-dependent magnetic resonance imaging （BOLD-MRI） is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen...Background： Blood oxygenation level-dependent magnetic resonance imaging （BOLD-MRI） is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen concentration. The purpose of this study was to investigate whether BOLD-MRI could evaluate hypoxia and angiogenesis of breast invasive ductal carcinoma （IDC）. Methods： Ninety-eight female patients with IDC were retrospectively included in this research. All patients underwent breast BOLD-MRI at 3.0 T before surgery. R2＊ values of BOLD-MR1 were measured. The expression of carbonic anhydrase IX （CA IX） and vascular endothelial growth factor （VEGF） was analyzed by immunohistochemistry. Spearman＇s correlation analysis was used to correlate R2＊ value with CA IX and VEGF levels. Results： Heterogeneous intensity on BOLD-MRI images was the main finding of IDCs. The mean R2＊ value was 52.8 ± 18.6 Hz. The R2＊ values in patients with axillary lymph node metastasis were significantly higher than the R2＊ values in patients without axillary lymph node metastasis （t = 2.882, P = 0.005）. R2＊ values increased with CA IX level and positively correlated with the level of CA 1X （r = 0.616, P 〈 0.001）; however, R2＊ value had no significantly correlation with the level of VEGF （r = 0.110, P = 0.281）. Conclusion： B OLD-MRI could noninvasively evaluate chronic hypoxia of IDC, but not angiogenesis.展开更多
文摘目的探讨基于MRI、钼靶影像特征联合临床病理因素构建的列线图在预测肿块型乳腺浸润性导管癌前哨淋巴结(sentinel lymph node,SLN)转移中的价值。材料与方法回顾性分析经病理证实为浸润性导管癌患者的临床病理及影像资料312例,按3∶1随机分成训练组(234例)与验证组(78例),两组间比较采用χ2检验或Fisher精确检验。在训练组中,SLN阴性组158例,阳性组76例,对两组患者的临床病理因素、MRI、钼靶影像特征进行分析。通过多因素Logistic回归分析筛选出独立预测因子,构建预测SLN转移的列线图模型。使用受试者操作特征(receiver operating characteristic,ROC)曲线、校准曲线、Hosmer-Lemeshow检验拟合优度对模型进行评价。结果临床病理因素、MRI、钼靶影像特征在训练组及验证组间差异无统计学意义(P>0.05)。在训练组中,肿瘤最大径、临床T分期、淋巴结触诊、孕激素受体、人类表皮生长因子受体2、脉管浸润、MRI[肿块形状、乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类、腋窝淋巴结状态]、钼靶(BI-RADS分类、腋窝淋巴结状态)这11个变量在SLN阴性组和阳性组间差异有统计学意义(P<0.05)。通过多因素Logistic回归分析得到,肿瘤最大径、淋巴结触诊、MRI(腋窝淋巴结状态)、钼靶(腋窝淋巴结状态)以及脉管浸润为预测SLN转移的独立危险因素。基于这5个变量构建模型,训练组及验证组ROC曲线下面积分别为0.908和0.897;Hosmer-Lemeshow检验拟合优度P值分别为0.883和0.579(P>0.05)。结论基于MRI及钼靶的术前影像学特征联合临床病理因素构建的列线图模型能较好地预测肿块型浸润性导管癌患者SLN转移情况。
文摘目的探讨能谱CT曲线在判断乳腺浸润性导管癌(IDC)分化程度中的价值。方法回顾性分析经手术病理证实并术前行能谱CT扫描的54例IDC患者的资料,分为高分化组(病理Ⅰ、Ⅱ级)44例、低分化组(病理Ⅲ级)10例,测量并分别比较动脉期和静脉期两组的能谱曲线(40~100 keV)的规律、差异。采用受试者工作特征曲线(ROC)分别分析比较动、静脉期能谱曲线斜率对IDC分化程度的诊断效能。结果在40~100 ke V,低分化组能谱曲线斜率高于高分化组能谱曲线斜率,差异具有统计学意义(P<0.05);ROC曲线显示:动脉期高-低分化组以斜率k=1.47作为诊断阈值,曲面下面积(AUC)为0.83,敏感度为68.09%,特异度为86.67%;静脉期高-低分化组以斜率k=1.74作为诊断阈值,AUC为0.78,敏感度为91.49%,特异度为58.33%。结论IDC的能谱曲线斜率可于术前提示其病理组织分化程度。
文摘Background： Blood oxygenation level-dependent magnetic resonance imaging （BOLD-MRI） is a functional MRI technique which involves using the paramagnetic properties of deoxyhemoglobin to image the local tissue oxygen concentration. The purpose of this study was to investigate whether BOLD-MRI could evaluate hypoxia and angiogenesis of breast invasive ductal carcinoma （IDC）. Methods： Ninety-eight female patients with IDC were retrospectively included in this research. All patients underwent breast BOLD-MRI at 3.0 T before surgery. R2＊ values of BOLD-MR1 were measured. The expression of carbonic anhydrase IX （CA IX） and vascular endothelial growth factor （VEGF） was analyzed by immunohistochemistry. Spearman＇s correlation analysis was used to correlate R2＊ value with CA IX and VEGF levels. Results： Heterogeneous intensity on BOLD-MRI images was the main finding of IDCs. The mean R2＊ value was 52.8 ± 18.6 Hz. The R2＊ values in patients with axillary lymph node metastasis were significantly higher than the R2＊ values in patients without axillary lymph node metastasis （t = 2.882, P = 0.005）. R2＊ values increased with CA IX level and positively correlated with the level of CA 1X （r = 0.616, P 〈 0.001）; however, R2＊ value had no significantly correlation with the level of VEGF （r = 0.110, P = 0.281）. Conclusion： B OLD-MRI could noninvasively evaluate chronic hypoxia of IDC, but not angiogenesis.
