高场强IVIM、T1灌注对乳腺肿瘤诊断价值比较及与MVD相关性

Comparison of Diagnostic Value of High-field IVIM with T1 Perfusion in Breast Tumors and Its Correlation to MVD

目的:探讨体素内不相干运动磁共振扩散加权成像(IVIM-DWI)、T1灌注对乳腺肿瘤的诊断价值并分析与肿瘤血管密度(MVD)相关性。方法:收集2016~2017年经穿刺或手术病理证实乳腺肿瘤患者72例,其中恶性病灶44个和良性病灶39个。所有病例术前均行IVIM-DWI、T1灌注扫描。其中IVIM采用的b值分别为10、20、50、100、200、500、1 000 s·mm^(-2)。将图像传入GEAW4.6后处理工作站,得出f、D*及D值,T1灌注经定量分析软件测量出病灶的K^(trans),K_(ep)利用所得数据对乳腺肿瘤良恶性进行诊断,与病理结果比较,分别得出乳腺癌诊断的准确性、敏感性、特异性。结合免疫组化后肿瘤血管密度,分析对他们之间相关性。结果:IVIM-DWI诊断乳腺癌的敏感性90.7%,特异性87.5%,准确性88.6%;而T1灌注分别为81.4%、77.5%、79.5%;两者结果比较,P>0.05,差异无统计学意义;恶性肿瘤的MVD大于良性肿瘤。结论:IVIM-DWI对乳腺癌诊断有较高敏感性、特异性及准确性,与T1灌注比较没有明显差异。且f值与MVD、K^(trans)值呈正相关,MDV与D值呈负相关。

Objective： To investigate the diagnostic value of intravoxel incoherent motion diffusion-weighted imaging（ IVIM-DWI） and T1 perfusion in the diagnosis of breast tumors and to analyze its correlation with tumor vascular density（ MVD）. Methods： A total of 72 patients with breast tumors confirmed by puncture or biopsy were collected from 2016 to2017,including 44 malignant lesions and 39 benign lesions. All patients underwent IVIM-DWI and T1 perfusion scan before operation. Furthermore,the b values of IVIM-DWI were 10,20,50,100,200,500 and 1 000 s·mm^（-2）,respectively. All images were passed into GEAW4. 6 workstation for post-processing to figure out the values of f,D＊,and D.Ktrans of lesion was measured by quantitative analysis software in T1 perfusion.. Benign and malignant breast tumors were diagnosed via data analysis in Kep of the lesion. Compared with the pathological results,the diagnostic accuracy,sensitivity and specificity of breast cancer were obtained. The correlation between them. was analyzed combined with tumor vascular density after immunohistochemistry. Results： The sensitivity,specificity and accuracy of IVIM-DWI in the diagnosis of breast cancer were 90. 7%,87. 5%,and 88. 6%,respectively,while those of T1 perfusion were 81. 4%,77. 5%,79. 5%,respectively. There was no significant difference between the two results（ P = 0. 088 0. 05）. The MVD of malignant tumor is larger than that of benign tumor. Conclusion： IVIM-DWI has the high sensitivity,specificity and accuracy in the diagnosis of breast cancer,but there is no significant difference compared to T1 perfusion. The f value is positively correlated with MVD and Ktrans values,and MDV is negatively correlated with D value.