摘要
目的探讨定量动态增强磁共振 (DCE-MRI)感兴趣区(ROI)勾画技术在乳腺 癌诊断中的临床价值。方法 收集2015年 1月-2017年6月在我院行乳腺DCE-MRI检 查的57例女性患者,行感兴趣区(ROI)勾 画,测定容量转运常数(Ktrans)、反流速度 常数(Kep)、血管外细胞外间隙容积(Ve), 比较乳腺癌、良性乳腺病变及正常腺体 上述参数差异,并采用ROC曲线分析各定 量参数对乳腺性质的诊断效能。结果 三 组Ktrans、Kep、Ve比较差异有统计学意义 (P<0.05);良性病变组或乳腺癌组较正常 腺体组Ktrans、Kep明显增大(P<0.05),Ve明 显减小(P<0.05);乳腺癌组较良性病变组 Ktrans、Kep明显增大(P<0.05),Ve明显减小 (P<0.05)。Ktrans、Kep、Ve诊断乳腺良恶性 的ROC曲线下面积分别为0.802、0.915、 0.736,敏感度分别为92.26%、92.34%、 83.17%,特异度分别为58.25%、74.68%、 66.62%;而Ktrans联合Kep诊断的ROC曲线 下面积为0.941,敏感度为97.33%,特异 度为83.49%。结论 DCE-MRI的定量参数 Ktrans、Kep、Ve对于乳腺良恶性诊断有重要 价值,且Ktrans联合Kep能够提高诊断效能。
Objective To explore the clinical value of quantitative dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) region of interest (ROI) delineation in the diagnosis of breast cancer. Methods 57 female patientsexamined by DCE-MRI in the hospital from January 2015 to June 2017 were selected, and ROI delineation was performed. The volume transfer constant (Ktrans), reflux velocity constant (Kep) and extravascular space volume (Ve) were measured. The above parameters were compared among breast cancer, benign breast lesions and normal glands. The diagnostic efficiencies of different quantitative parameters for breast properties were analyzed by ROC curve. Results There were statistically significant differences of Ktrans, Kep and Ve among the three groups (P<0.05). The Ktrans and Kep showed the breast cancer group > the benign lesion group > the normal gland group (P<0.05), while Ve showed the breast cancer group < the benign lesion group < the normal gland group (P<0.05). The areas under ROC curve of Ktrans, Kep and Ve in the diagnosis of benign and malignant breast lesions were 0.802, 0.915 and 0.736 respectively, the sensitivities were 92.26%, 92.34% and 83.17% respectively, and the specificities were 58.25%, 74.68% and 66.62%, respectively. The area under ROC curve of Ktrans combined with Kep was 0.941, the sensitivity and specificity were 97.33% and 83.49% respectively. Conclusion The quantitative parameters of DCE-MRI, Ktrans, Kep and Ve are of great value in the diagnosis of benign and malignant breast lesions. Besides, Ktrans combined with Kep can improve the diagnostic efficiency.
【关键词】乳腺癌;定量动态增强磁共振;感兴趣区勾画;诊断价值
【中图分类号】R737.9
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.08.026
前言
乳腺癌是女性常见恶性肿瘤之一,近年来其发病率逐渐增高,且 呈年轻化趋势,是女性癌症死亡的主要原因[1]。乳腺癌早期发现、明 确诊断对其治疗和预后尤为重要,然而早期乳腺癌缺乏典型症状、 体征,易出现误诊[2-3]。定量动态增强磁共振(dynamic contrastenhanced magnetic resonance imaging,DCE-MRI)是一种新型功能成 像技术,能够获取对比剂在血液分布及内外血管交换的动态信息,提 供反映肿瘤微循环、灌注等血流动力学定量参数,对肿瘤诊断及预后 评估有重要意义,临床应用逐渐广泛[4]。本研究旨在DCE-MRI及感兴趣 (region of interst,ROI)勾画获取定量参数在乳腺癌诊断中的临床价 值,现报告如下。
中国CT和MRI杂志
第16卷, 第 8 期
2018年08月
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