乳腺结节患者DCE-MRI定量参数与其病变良恶性的关系

Relationship between DCE-MRI Quantitative Parameters and Benign and Malignant Lesions in Patients with Breast Nodules

目的探究动态增强磁共振成像序列(DCEMRI)定量参数对乳腺结节患者病变良恶性的诊断价值。方法回顾性分析2020年1月至2023年9月我院收治的74例乳腺结节患者的临床资料,均行病理学诊断和DCE-MRI检查。以病理学结果为依据将患者分为良性组及恶性组,比较两组DCE-MRI影像学特征及定量参数血管外细胞外隙容积比(Ve)、回流速率常数(Kep)、容积转移常数(Ktrans)的差异,应用ROC分析和ROC曲线下面积(AUC)判断上述定量参数对乳腺结节良恶性病变鉴别诊断的价值。结果74例患者病理结果示,检出良性病变48例(64.86%),恶性病变者26例(35.14%),前者为良性组,后者为恶性组;两组DCE-MRI病灶形态、强化模式、TIC类型的特征对比,差异均有统计学意义(P<0.05);恶性组的Ktrans、Kep高于良性组,Ve低于良性组(P<0.05);以病理学结果为“金标准”绘制ROC曲线,Ktrans、Kep、Ve的AUC分别为0.906、0.867、0.645(P<0.05),提示Ktrans、Kep鉴别诊断乳腺结节病变良恶性的价值更高,且Ktrans灵敏度最高为80.77%,Kep特异度最高为97.92%。结论DCE-MRI定量参数Ktrans、Kep在乳腺结节恶性病变中呈现更高表达,对于乳腺结节良恶性病变具有较高的鉴别诊断价值,而Ve与对乳腺结节良恶性病变的关系仍需进一步研究。

Objective To explore the diagnostic value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)for benign and malignant lesions in patients with breast nodules.Methods A retrospective analysis was performed on the clinical data of 74 patients with breast nodules admitted to the hospital between January 2020 and September 2023.All underwent pathological diagnosis and DCE-MRI examination.According to pathological results,patients were divided into benign group and malignant group.The imaging characteristics and quantitative parameters of DCE-MRI[extravascular extracellular space volume fraction(Ve),reflux rate constant(Kep),volume transfer constant(Ktrans)]in the two groups were compared.The value of the above quantitative parameters in the differential diagnosis of benign and malignant breast nodules was determined by ROC analysis and area under ROC curve(AUC).Results In the 74 patients,pathological results showed that there were 48 cases(64.86%)with benign lesions in benign group and 26 cases(35.14%)with malignant lesions in malignant group.There were significant differences in lesion morphology,enhancement modes and TIC types between the two groups(P<0.05).Ktrans and Kep in malignant group were higher than those in benign group,while Ve was lower than that in benign group(P<0.05).Taking pathological results as the golden standard,ROC curves were drawn,AUC of Ktrans,Kep and Ve were 0.906,0.867 and 0.645,respectively(P<0.05).The value of Ktrans and Kep was higher in the differential diagnosis of benign and malignant breast nodules.The sensitivity of Ktrans was the highest(80.77%),and specificity of Kep was the highest(97.92%).Conclusion The expressions of DCEMRI quantitative parameters Ktrans and Kep are higher in malignant lesions of breast nodules,which have high value in the differential diagnosis of benign and malignant lesions.However,the relationship between Ve and benign and malignant lesions still needs further study.