磁共振部分参数与乳腺癌血管病变严重程度的相关性分析

目的分析1．5T动态增强磁共振成像（DCE．MRI）参数对乳腺癌患者不良预后的预测价值。方法选择2013年2月至2016年11月140侧经病理证实的乳腺癌患者，包括82例浸润性导管癌，20例浸润性小叶癌，12例粘液腺癌，4例髓样癌，20例单纯癌，2例多形性癌。回顾性分析MRI多参数与血管病变的微血管密度（MVD）计数及胞浆血管内皮生长因子（VEGF）的相关性。结果MRI参数：时间．信号强度曲线（TICtype）、达峰时间（Tpeak）以73kMIP图血管计数（NTV）与乳腺癌的MVD及VEGF呈正相关，差异有统计学意义（P〈0．05）；参数：早期增强率（EER）、最大线性斜率（Slope）以及最大强化率（Slmax）与乳腺癌的MVD及VEGF的相关性不明显，差异无统计学意义（P〉0．05）。结论1．5TDCE-MRI参数能较为准确地反映肿瘤血管病变严重性和不良预后，对于临床治疗和疗效观察具有指导意义。

Objective To explore the relationship between 1.5T dynamic contrast-enhanced （ DCE ） MRI parameters and poor prognosis of the patients with breast cancer. Methods 140 patients with pathologically confirmed breast cancer, including 82 patients with infiltrating duct cancer, 20 with infiltrating lobular carcinoma, 12 with mucinous adenocarcinoma, 4 with medullary carcinoma, and 20 patients with simple cancer, 2 patients with pleomorphic carcinoma were enrolled from February 2013 to November 2016. The relationship between MILl parameters and microvessel density （ MVD ） and vascular endothelial growth factor （ VEGF ） was analyzed retrospectively. Results The MRI parameters： the type of time-signal intensity curve （ TIC ） , peak time （ Tpeak ） and the number ofturnor vessels on maximum intensity projection map （ NTV ） were positively correlated with MVD and VEGF of breast cancer, the difference was statistically significant （ P〈0.05 ） . Early-phase enhancement rate （ EER ） , maximum linear slope rate （ Slope ） and maximum enhancement rate （ Slmax ） were not correlated with MVD and VEGF in breast cancer, the difference was not statistically significant （ P〉0.05 ） . Conclusion 1.5T DCE-MRI parameters can accurately demonstrate the severity and poor prognosis of tumor vascular lesions in patients with breast cancer, which is of great significance for clinical treatment and observation of curative effect.