磁共振成像动态增强扫描定量参数在乳腺良恶性结节鉴别诊断中的效能

Efficiency of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging in differential diagnosis of breast nodules

目的:分析磁共振成像动态增强扫描(DCE-MRI)定量参数在乳腺良恶性结节鉴别诊断中的效能。方法:回顾性分析2021年4月至2023年4月该院收治的68例乳腺结节患者的临床资料,根据病理学检查结果将其分为良性组38例与恶性组30例。所有患者均行DCE-MRI检查,比较两组影像学特征、DCE-MRI定量参数[速率常数(K_(ep))、容量转移常数(K^(trans))、血管外细胞外间隙容积比(V_(e))、增强曲线下初始面积(iAUC)]水平,绘制受试者工作特征(ROC)曲线,分析DCE-MRI定量参数K^(trans)、V_(e)单项及联合检测在乳腺良恶性结节鉴别诊断中的效能。结果:恶性组形状不规则、边缘有毛刺征、内部强化不均匀、早期增强率≥60%占比均高于良性组,差异有统计学意义(P<0.05);恶性组K^(trans)、V_(e)均高于良性组,差异有统计学意义(P<0.05);ROC曲线分析结果显示,K^(trans)、V_(e)单项及联合检测鉴别乳腺良恶性结节的曲线下面积分别为0.797、0.788、0.934,均具有一定诊断效能,且联合检测诊断效能最高。结论:DCE-MRI定量参数Ktrans、Ve水平联合检测鉴别乳腺良恶性结节的效能高于二者单项检测。

Objective:To analyze efficiency of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in differential diagnosis of breast nodules.Methods:The clinical data of 68 patients with breast nodules admitted to this hospital from April 2021 to April 2023 were retrospectively analyzed.According to the results of pathological examination,they were divided into benign group(38 cases)and malignant group(30 cases).All patients underwent DCE-MRI examination.The imaging findings and the DCE-MRI quantitative parameters[rate constant(K_(ep)),volume transfer constant(K^(trans)),extravascular extracellular space volume ratio(Ve),initial area under timeconcentration curve(iAUC)]were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the efficiency of single and combined detection of DCE-MRI quantitative parameters K^(trans)and Ve levels in the differential diagnosis of breast nodule properties.Results:The proportions of irregular shape,burr sign on the edge,uneven internal enhancement and early enhancement rate≥60%in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).The levels of K^(trans)and V_(e)in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).The ROC curve analysis showed that the area under the curve of single K^(trans)detection,single Ve detection and combined detection in the diagnosis of breast nodules were 0.797,0.788 and 0.934,respectively,all of which had certain diagnostic value,and the combined detection had the highest diagnostic efficiency.Conclusions:The efficiency of combined detection of DCE-MRI quantitative parameters K^(trans)and V_(e)levels in the diagnosis of breast nodules is higher than those of single detection.