动态增强MRI定量参数对乳腺良恶性肿瘤的鉴别诊断价值

The Value of DCE-MRI Quantitative Parameters in Differential Diagnosis of Benign and Malignant Breast Tumors

目的探讨动态增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)定量参数对乳腺良恶性肿瘤的鉴别能力。方法搜集经手术病理证实的乳腺肿瘤患者38例,其中良性肿瘤14例,恶性肿瘤24例,术前均行DCE-MRI扫描,选取感兴趣区测量肿瘤的DCE-MRI定量参数K^(trans)(容量转移常数)、K_(ep)(速率常数)、V_e(血管外细胞外间隙容积比)。采用独立样本t检验比较良、恶性肿瘤组间定量参数的差异,绘制ROC曲线分析定量参数对乳腺良、恶性肿瘤的诊断效能。结果乳腺良性肿瘤组K^(trans)、K_(ep)、V_e平均值分别为(0.134±0.121)min^(-1)、(0.273±0.137)min^(-1)、(0.633±0.096);乳腺恶性肿瘤组K^(trans)、K_(ep)、V_e平均值分别为(0.339±0.128)min^(-1)、(0.515±0.169)min^(-1)、(0.680±0.116)。K^(trans)、K_(ep)在良、恶性肿瘤组间差异均有统计学意义(P<0.001)。V_e在良、恶性肿瘤组间差异无统计学意义(P>0.05)。以最大约登指数确定最佳诊断界值,K^(trans)、K_(ep)的敏感性、特异性和ROC曲线下面积分别为89.17%、93.83%;94.56%、85.71%和0.929、0.902。结论定量参数K^(trans)、K_(ep)可作为乳腺良、恶性肿瘤鉴别诊断的参考指标,且有较高的诊断效能。

Objective To explore the differential diagnosis value of dynamic contrastenhanced MRI（DCE-MRI） quantitative parameters of benign and malignant breast tumors. Methods 14 cases with benign breast tumors, 24 cases with malignant breast tumors confirmed by operation, underwent the examination of DCE-MRI. ROI were drawn to record the quantitative parameters average values of K^（trans）, K_（ep）, V_e. The quantitative parameters between benign and malignant breast tumors were compared by independent samples t-test. The areas under the ROC curve of the quantitative parameters between benign and malignant breast tumors were compared. Results The average values of K^（trans）, K_（ep）, V_e in benign breast tumors were（0.134±0.121） min^（-1）,（0.273±0.137） min^（-1）,（0.633±0.096）. The average values of K^（trans）, K_（ep）, V_e in malignant breast tumors were（0.339±0.128） min^（-1）,（0.515±0.169） min^（-1）,（0.680±0.116）. The difference of K^（trans）, K_（ep） between benign and malignant tumors were statistically significant（P〈0.001）. The difference of V_e between benign and malignant tumors was not statistically significant（P=0.213）. Using the maximum Youden index as the cut-off value, the sensitivity of K^（trans）, K_（ep） were 89.17%, 93.83%. The specificity of K^（trans）, K_（ep） were 94.56%, 85.71%. The area under the ROC curve of K^（trans）, K_（ep） were 0.929, 0.902. Conclusion The differential diagnosis of benign and malignant breast tumors by quantitative parameters K^（trans）, K_（ep） were applicable.