DWI和DCE-MRI的影像特征对不同分子亚型乳腺癌的诊断价值探讨

The Diagnostic Value of DWI and DCE-MRI Images for Different Molecular Subtypes of Breast Cancer

目的:对乳腺癌患者进行MRI检查,分析不同分子亚型的弥散加权成像(DWI)与动态增强MRI(DCE-MRI)特点,对其诊断价值进一步探究。方法:本次研究对象为本院2019年3月至2021年8月期间收治的87例乳腺癌患者,所有患者经乳腺癌手术行病理确诊为4种分子亚型,予以患者MRI扫查与增强扫描,通过工作站分析DWI、DCE-MRI图像与数据。结果:分子分型分类中的IER值、ADC值和影像组学标签,各组分子分型应用,IER值、ADC鉴别时,AUC值均低于0.7,鉴别能力差。TN经DCE_bior3.1_3_correlation鉴别的AUC为0.939。0.939为鉴别非TN与TN型的AUC值;0.736为鉴别非Luminal B与Luminal B型的AUC值;0.789为非Luminal A型、Luminal A型的AUC值。结论:IER值、ADC值未能将乳腺癌4种分子亚型进行鉴别,DCE-MRI与DWI鉴别分子亚型的临床价值显著,特别是TN型鉴别优势更大。

Objective:To analyze the characteristics of diffusion-weighted imaging(DWI)and dynamic enhanced MRI(DCE-MRI)of different molecular subtypes of breast cancer patients by MRI examination,and to further explore the diagnostic value of dCE-MRI.Methods:The subjects of this study were 87 patients with breast cancer admitted to our hospital from March 2019 to August 2021.All patients were pathologically diagnosed with 4 molecular subtypes after breast cancer surgery.Patients were subjected to MRI and enhanced scanning,and DWI and DCE-MRI images and data were analyzed by workstation.Results:IER value,ADC value,image omics label,application of molecular typing,IER value and ADC identification,AUC value were all lower than 0.7,indicating poor identification ability.The AUC of TN by DCE_BIOR3.1_3_correlation was 0.939.0.939 is the AUC value for distinguishing non-TN from TN type;0.736 is the AUC value for distinguishing non-Luminal B from Luminal B type;0.789 is the AUC value of non-Luminal A and Luminal A type.Conclusion:IER value and ADC value are not able to identify the four molecular subtypes of breast cancer.Dce-mri and DWI have significant clinical value in differentiating molecular subtypes,especially TN type.