增强MRI扫描联合超声血流参数对乳腺癌的诊断价值

Flow parameters of enhanced MRI scan combined with ultrasound in diagnosis of breast cancer

目的探讨增强MRI扫描联合超声血流参数对乳腺癌的诊断价值。方法选取2020年1月至2023年1月黄石市中心医院收治的80例行影像学检查的疑似乳腺癌患者为研究对象,依照临床病理检查结果分为对照组(13例)和确诊组(67例)。其中,对照组患者年龄(53.12±8.79)岁;确诊组患者年龄(54.35±7.96)岁。比较乳腺癌患者采用两种检查方式的诊断结果,比较两组患者血流的增强MRI扫描参数[量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)]和超声参数[血流搏动指数(PI)、血流阻力指数(RI)、峰值流速(PSV)]。计量资料和计数资料分别采用t检验和χ^(2)检验,使用受试者操作特征曲线(ROC)评估增强MRI扫描参数和超声参数单独及其联合检测对乳腺癌的诊断价值。结果确诊的67例乳腺癌患者中,采用增强MRI和超声检查的确诊率[91.04%(61/67)比92.54%(62/67)]比较差异无统计学意义(P>0.05),但增强MRI的误诊率高于超声检查[6.15%(4/67)比0,P<0.05]。绘制ROC结果显示,单独Ktrans[曲线下面积(AUC)=0.711]、Kep(AUC=0.739)、PI(AUC=0.756)、RI(AUC=0.846)和PSV(AUC=0.755)水平在乳腺癌患者诊断中均有一定价值。增强MRI的两种参数联合诊断的AUC为0.790,3种超声参数联合诊断的AUC为0.928,这5种参数联合诊断的AUC为0.954。结论乳腺癌患者血流的增强MRI扫描参数和超声参数均偏高,采用增强MRI与超声联合检查具有一定临床价值。

Objective To investigate the diagnostic value of blood flow parameters of enhanced MRI scan combined with ultrasound for breast cancer.Methods Eighty patients with suspected breast cancer treated at Huangshi Central Hospital from January 2020 to January 2023 were selected as the study objects and divided into a control group(13 cases)and a confirmed group(67 cases)according to the clinical and pathological examination results.The control group were(53.12±8.79)years old,and the confirmed group(54.35±7.96).The diagnostic results by the two methods were compared.The enhanced MRI scan parameters[volume transfer constant(Ktrans),rate constant(Kep),and vascular extracellular space volume ratio(Ve)]and ultrasound parameters[(blood beat index(PI),flow resistance index(RI),and peak flow rate(PSV)]were compared between the two groups.Comparisons of the measurement and count data were performed using the t test andχ^(2) test,respectively.The diagnostic values of enhanced MRI scan parameters and ultrasound parameters alone and their combination for breast cancer were evaluated using the receiver operating characteristic curve(ROC).Results In the 67 patients confirmed with breast cancer,there was no statistical difference in the accurate diagnostic rate between the MRI and ultrasound[91.04%(61/67)vs.92.54%(62/67);P>0.05],but the MRI had a higher misdiagnosis rate than ultrasound[6.15%(4/67)vs.0;P<0.05].The results of the ROC showed that individual Ktrans[area under the curve(AUC)=0.711],Kep(AUC=0.739),PI(AUC=0.756),RI(AUC=0.846),and PSV(AUC=0.755)had some value in breast cancer diagnosis.The AUC of the combination of the 2 enhanced MRI scan parameters was 0.790;the AUC of the combination of the 3 ultrasound parameters was 0.928;the AUC of the combination of the 5 parameters was 0.954.Conclusion The enhanced MRI scan parameters and ultrasound parameters of blood flow in patients with breast cancer are high.The combination of MRI and ultrasound is of some clinical value.