体素内不相干运动成像鉴别乳腺良恶性病变的价值并与定量动态增强MRI对比

发布时间：2018-06-11 12:03

  本文选题：乳腺肿瘤 + 磁共振成像　； 参考：《中国癌症杂志》2017年10期

【摘要】：背景与目的:乳腺癌是女性最常见的恶性肿瘤,体素内不相干运动(intravoxel incoherent motion,IVIM)是近年来发展的基于双指数计算模型的功能成像方法,可反映单纯扩散和灌注两种效应。该研究旨在探讨IVIM各参数的可重复性及鉴别诊断乳腺良恶性病变的价值,与定量动态增强MRI(dynamic contrast enhanced-magnetic resonance imaging,DCE-MRI)比较,并探讨两种成像方法灌注参数的相关性。方法:收集发现乳腺占位性病变并获得术后明确病理结果的患者56例,共61个病灶,其中良性病变30个,恶性病变31个。患者术前均行IVIM及DCE-MRI检查。2名放射科医师独立对图像进行后处理,获得IVIM参数(D、D~*、f值),DCE-MRI参数(K~(trans)、K_(ep)、V_e值)。采用组内相关系数(intraclass correlation coefficients,ICC)检测2名医师IVIM测量值的一致性;采用独立样本t检验比较乳腺良恶性病变各参数值的差异;对于差异有统计学意义的参数采用受试者工作特征(receiver operating characteristic,ROC)曲线评价其鉴别诊断乳腺良恶性病变的效能;采用Pearson相关分析比较IVIM灌注相关参数与DCE-MRI的相关性。结果:2名医师IVIM测量值的组内、组间重复性均较好(ICC≥0.730,P均0.05)。乳腺恶性病变的D值低于良性病变,而f、K~(trans)及K_(ep)值高于良性病变,差异均有统计学意义(P0.05),D~*、V_e值差异均无统计学意义(P0.05)。D、f、K~(trans)、K_(ep)值鉴别诊断乳腺良恶性病变的ROC下面积分别为0.896、0.677、0.796、0.847。D与K~(trans)、K_(ep)的ROC下面积差异无统计学意义(P0.05)。以1.07×10~(-3) mm~2/s为诊断阈值,D值特异度最高(86.67%),以0.54/min为诊断阈值,K_(ep)值的灵敏度最高(98.36%)。相关分析显示f与K~(trans)、K_(ep)值及D~*与K~(trans)值均呈弱正相关,相关系数r分别为0.373、0.360和0.294(P?均0.05)。结论:IVIM参数在不同医师分析中重复性较好,IVIM与DCE-MRI均有助于鉴别诊断乳腺良恶性病变,两种成像方法在反映组织灌注情况中存在相关性。
[Abstract]:Background & objective: breast cancer is the most common malignant tumor in women. Intra voxel incoherent motionIVIMA is a new functional imaging method developed in recent years, which can reflect both diffusion and perfusion effects. The purpose of this study was to investigate the reproducibility of contrast enhanced-magnetic resonance parameters and the value of differentiating benign and malignant breast lesions, and to compare them with quantitative dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI), and to explore the correlation between the perfusion parameters of the two imaging methods. Methods: a total of 61 lesions including 30 benign lesions and 31 malignant lesions were collected. All the patients underwent IVIM and DCE-MRI examination before operation. 2 radiologists independently processed the images. The parameters of IVIM and DCE-MRI parameters were obtained. The consistency of two physicians was measured by intraclass correlation coefficients, and the difference of parameters between benign and malignant breast lesions was compared by independent sample t-test. The effectiveness of differential diagnosis of benign and malignant breast lesions was evaluated by receiver operating characteristic ROCcurve, and the correlation between perfusion parameters and DCE-MRI was compared by Pearson correlation analysis. Results the reproducibility of IVIM measured by two physicians was better than that of the control group (ICC 鈮，

本文编号：2005143