不同海拔地区浸润性乳腺癌女性患者MRI动态增强扫描血流动力学参数的差异

Difference of hemodynamic parameters of MRI dynamic enhanced scanning in female patients with invasive breast cancer at different altitudes

目的探讨不同海拔地区浸润性乳腺癌女性患者MRI动态增强扫描血流动力学参数的差异。方法选取92例浸润性乳腺癌女性患者,根据患者长期居住地海拔分为高原组(居住区域海拔≥3000 m)43例与非高原组(居住区域海拔<3000 m)49例。所有患者术前均进行乳腺MRI动态增强扫描检查。比较两组患者的定量参数[容积转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积(V_(e))]与半定量参数[动态增强时间—信号强度曲线(TIC)、最大增强斜率(MaxSlope)、初始增强曲线下面积(IAUGC)、正向增强积分(PEI)、对比增强比率(CER)]。结果高原组TIC类型以Ⅲ型为主,MaxSlope、IAUGC、K^(trans)、K_(ep)均大于非高原组(均P<0.05),但两组患者的PEI、CER、V_(e)差异均无统计学意义(均P>0.05)。结论不同海拔地区的浸润性乳腺癌女性患者的MRI动态增强扫描血流动力学参数存在一定差异,高原地区的浸润性乳腺癌女性患者的K^(trans)、K_(ep)、IAUGC、MaxSlope更大,且TIC类型以Ⅲ型为主。

Objective To explore the difference of hemodynamic parameters of MRI dynamic enhanced scanning in female patients with invasive breast cancer at different altitudes.Methods Ninety-two female patients with invasive breast cancer were selected,and they were divided into plateau group(altitude of residential region≥3000 m,43 cases)or non-plateau group(altitude of residential region<3000 m,49 cases)according to altitude of long-term residential region in patients.All patients underwent preoperative examination of breast MRI dynamic enhanced scanning.The quantitative parameters in terms of volume transfer constant(K^(trans)),velocity constant(K_(ep)),and extravascular extracellular space volume(V_(e)),and semi-quantitative parameters with respect to dynamic enhancement time-signal intensity curve(TIC),maximum slope of increase(MaxSlope),initial area under gadolinium curve(IAUGC),positive enhancement integral(PEI),and contrast enhancement ratio(CER)were compared between the two groups.Results TIC type of the plateau group was mainly typeⅢ,and MaxSlope,IAUGC,K^(trans) and K_(ep) of the plateau group were larger than those of the non-plateau group(all P<0.05);however,there was no statistically significant difference in PEI,CER,and V_(e) between the two groups(all P>0.05).Conclusion There are differences of hemodynamic parameters of MRI dynamic enhanced scanning in female patients with invasive breast cancer at different altitudes to a certain extent.Female patients with invasive breast cancer at plateau region obtain larger K^(trans),K_(ep),IAUGC,and MaxSlope,and TIC type is mainly typeⅢ.