Discrimination of Metastatic from Non-metastatic Mesorectal Lymph Nodes in Rectal Cancer Using Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Preoperative detection of lymph nodes（LNs） metastasis is always highly challenging for radiologists nowadays. The utility of quantitative dynamic contrast-enhanced magnetic resonance imaging（QDCE-MRI） in identifying LNs metastasis is not well understood. In the present study, 59 patients with histologically proven rectal carcinoma underwent preoperative QDCE-MRI. The short axis diameter ratio, long axis diameter ratio, short-to-long axis diameter ratio and QDEC-MRI parameters（Ktrans, Kep, fPV and Ve） values were compared between the non-metastatic（n=44） and metastatic（n=35） LNs groups based on pathological examination. Compared with the non-metastatic group, the metastatic group exhibited significantly higher short axis diameter（7.558±0.668 mm vs. 5.427±0.285 mm）, Ktrans（0.483±0.198 min-1 vs. 0.218±0.116 min^-1） and Ve（0.399±0.118 vs. 0.203±0.096） values（all P〈0.05）. The short-to-long axis diameter ratio, long axis diameter ratio, Kep and fPV values did not show significant differences between the two groups. In conclusion, our results showed that for LNs larger than 5 mm in rectal cancer, there are distinctive differences in the Ktrans and Ve values between the metastatic and non-metastatic LNs, suggesting that QDCE-MRI may be potentially helpful in identifying LNs status.

Correlation of dynamic contrast-enhanced ultrasonography and the Ki-67 labelling index in pancreatic ductal adenocarcinoma

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy.Dynamic contrast-enhanced ultrasonography(DCE-US)plays a crucial role in abdominal tumor diagnosis,and can adequately show the microvascular composition within the tumors.However,the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.AIM To predict the correlation between Ki-67 expression and the parameters of DCEUS.METHODS Patients with PDAC who underwent DCE-US were retrospectively analyzed.Patients who had received any treatment(radiotherapy or chemotherapy)prior to DCE-US;had incomplete clinical,imaging,or pathologic information;and had poor-quality image analysis were excluded.Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis.The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.RESULTS Based on the Ki-67 labelling index,30 patients were divided into two groups,i.e.,the high expression group and the low expression group.Among the relative quantitative parameters between the two groups,relative half-decrease time(rHDT),relative peak enhancement,relative wash-in perfusion index and relative wash-in rate were significantly different between two groups(P=0.018,P=0.025,P=0.028,P=0.035,respectively).The DCE-US parameter rHDT was moderately correlated with Ki-67 expression,and rHDT≥1.07 was more helpful in accurately diagnosing high Ki-67 expression,exhibiting a sensitivity and specificity of 53.8%and 94.1%,respectively.CONCLUSION One parameter of DCE-US,rHDT,correlates with high Ki-67 expression.It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.

Application of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with magnetic resonance spectroscopy(MRS)in prostate cancer diagnosis

Objective The aim of the study was to investigate the application of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with magnetic resonance spectroscopy(MRS)in prostate cancer diagnosis.Methods In the outpatient department of our hospital(Sichuan Cancer Hospital,Chengdu,China),60 patients diagnosed with prostate disease were selected randomly and included in a prostate cancer group,60 patients with benign prostatic hyperplasia were included in a proliferation group,and 60 healthy subjects were included in a control group,from January 2013 to January 2017.Using Siemens Avanto 1.5 T high-field superconducting MRI for DCE-MRI and MRS scans,after the MRS scan was completed,we used the workstation spectroscopy tab spectral analysis,and eventually obtained the crest lines of the prostate metabolites choline(Cho),creatine(Cr),citrate(Cit),and the values of Cho/Cit,and(Cho+Cr)/Cit.Results Participants who had undergone 21-s,1-min,and 2-min dynamic contrast-enhanced MR revealed significant variations among the three groups.The spectral analysis of the three groups revealed a significant variation as well.DCE-MRI and MRS combined had a sensitivity of 89.67%,specificity of 95.78%,and accuracy of 94.34%.Conclusion DCE-MRI combined with MRS is of great value in the diagnosis of prostate cancer.

Evaluation of dynamic contrast-enhanced MRI in monitoring early response of locally advanced breast cancer to neoadjuvant chemotherapy

Objective： The aim of our study was to assess the value of dynamic contrast-enhanced magnetic resonance imaging （DMRI） in predicting early response to neoadjuvant chemotherapy （NAC） in patients with locally advanced breast cancer （LABC） and to assess the accuracy of DMRI in evaluating residual disease after NAC. Methods： DMRI were per- formed in 43 women with LABC （44 lesions, all were invasive ductal carcinoma） before, after the first and final cycle of NAC. Tumour volume, early enhanced ratio （El）, maximum enhanced ratio （Emax）, and maximum enhanced time （Tmax）, dynamic signal intensity-time curve were obtained during treatment. Residual tumour volumes obtained using DMRI were compared with pathological findings to assess the accuracy of DMRI. Results： After 1st cycle of NAC, the mean volume of responders decreased insignificantly, P 〉 0.05, but after NAC, mean volume of residual tumor decreased significantly （P 〈 0.01）. Morphol- ogy change： 29 cases showed a concentric shrinkage pattern while 7 cases showed a dendritic shrinkage pattern. Significant differences were found in El, Emax and Tmax between responders and non-responders （P 〈 0.05）. After 1st cycle of NAC, El, Emax and Tmax of responders changed significantly （P 〈 0.001）; while there is no significant change in non-responders （P 〉 0.05）. After NAC, dynamic signal intensity-time types were changed in responders, and tended to be significantly flat- tening, while no significant change was found in non-responders. The residual tumour volume correlation coefficient between DMRI and pathology measurements was very high （r = 0.866, P = 0.000）. Conclusion： DMRI is useful to evaluate the early response to NAC in LABC. The presence and volume of residual disease in LABC patients treated with NAC could be ac- curately evaluated by DMRI.

Correlation of dynamic contrast-enhanced MRI parameters of uterine sarcoma with sarcoma cell proliferation and invasion in lesions

Objective:To investigate the correlation of dynamic contrast-enhanced MRI parameters of uterine sarcoma with sarcoma cell proliferation and invasion in lesions.Methods: A total of 38 patients with uterine sarcoma undergoing surgical treatment in this hospital between August 2015 and June 2017 were selected as uterine sarcoma group, and 50 patients with uterine fibroids undergoing surgical treatment in this hospital during the same period were selected as uterine fibroids group. The differences in dynamic contrast-enhanced MRI parameter levels as well as the expression of proliferation and invasion-related genes in lesion tissue were compared between the two groups of patients. Pearson test was used to assess the internal relationship between dynamic contrast-enhanced MRI parameters of uterine sarcoma and sarcoma cell malignancy.Results: The ADC and TTP levels in uterine sarcoma group were lower than those in uterine fibroids group;AgNOR, KIT and c-kit mRNA expression in the lesion tissue of uterine sarcoma group were higher than those of uterine fibroids group whereas PTEN mRNA expression was lower than that of uterine fibroids group;HOXA10 and Dickkopf mRNA expression in the lesion tissue of uterine sarcoma group were lower than those of uterine myoma group whereas Matriptase, PDGF and PRL-3 mRNA expression were higher than those of uterine fibroids group. Correlation analysis showed that the ADC and TTP levels in patients with uterine sarcoma were directly correlated with the expression of proliferation genes and invasion genes in the lesion tissue.Conclusion: Dynamic contrast-enhanced MRI parameters of uterine sarcoma are significantly different from those of benign uterine fibroids, and the specific parameter levels are directly correlated with tumor cell proliferation and invasion activity.

Dynamic contrast-enhanced MRI parameters of breast cancer tissue and their correlation with cancer cell proliferation and invasion

Objective:To study the dynamic contrast-enhanced MRI (DCE-MRI) parameters of breast cancer tissue and their correlation with cancer cell proliferation and invasion.Methods: A total of 92 patients with breast mass who underwent surgical treatment in our hospital between July 2012 and June 2016 were collected as research subjects. According to the results of pathological examination, the patients were divided into breast adenoma group (n=52) and breast cancer group (n=40). DCE-MRI parameter levels of breast mass were analyzed between two groups of patients, and the mRNA expression of proliferation and invasion genes in tumor samples were compared. Pearson test was used to further evaluate the relationship between the DCE-MRI parameter levels of breast cancer tissue and the malignant degree of tumor.Results:The DCE-MRI parameter TTP level in breast cancer group was lower than that in breast adenoma group while EER and SLOPE levels were higher than those in breast adenoma group. Proliferation genes C6orf106, HMGB2, ETS-1 and BRG1 mRNA expression in tumor tissue of breast cancer group were higher than those of breast adenoma group, and invasion genes ADAM9, Ezrin and Nanog mRNA expression were higher than those of breast adenoma group while CRM197 and EBP50 mRNA expression were lower than those of breast adenoma group. The Pearson test showed that the DCE-MRI parameter levels of breast cancer tissues were directly correlated with the mRNA expression of proliferation and invasion genes.Conclusion:DCE-MRI parameter levels are abnormal in breast cancer tissues, and the abnormal degree is directly correlated with the malignant biological behavior of tumor cells.

Comparison of clinical value of dynamic contrast-enhanced MRI and SPECT renal dynamic imaging of GFR measurement in the evaluation of renal function in renal transplantation

Objective:To compare the clinical value of dynamic contrast-enhanced MRI(DCE-MRI)and single-photon emission computed tomography(SPECT)renal dynamic imaging in the measurement of glomerular filtration rate(GFR)in the evaluation of renal function in renal transplantation.Methods:A total of 70 recipients who underwent renal transplantation in Baogang Hospital of Inner Mongolia from April of 2015 to April of 2018 were selected as research objects.GFR was measured in renal transplant recipients by use of DCE-MRI and SPECT(GFR-MRI and GFR-SPECT respectively),and was compared with creatinine clearance rate(Ccr).The safety of contrast media was evaluated in DCE-MRI detection.Results:The bias of GFR-MRI against Ccr value was higher than that of GFR-SPECT against Ccr value,with 30%and 50%accuracy of GFR-MRI higher than that of GFR-SPECT,and the difference was statistically significant(p<.05).Pearson correlation analysis showed that GFR-MRI and GFR-SPECT values were positively correlated to Ccr(p<.05),and the correlation coefficient of GFR-MRI and Ccr was higher than that of GFR-SPECT and Ccr,with the difference statistically significant(p<.05).By Bland-Altman analysis,95%confidence interval of GFR-SPECT was 95.49 ml/(min·1.73 m^(2)),and 95%confidence interval of GFR-MRI was 62.35 ml/(min·1.73m^(2)),which was much narrower.Only 2 cases of patients developed mild rash among 70 cases of patients,and recovered spontaneously without any treatment.Conclusions:Compared with SPECT,the bias of GFR measured by DCE-MRI against Ccr is much greater.However,DCE-MRI has a higher accuracy,correlation and consistency in comparison with Ccr,and it has a narrower confidence interval.DCE-MRI can more accurately evaluate renal function in renal transplantation by measuring GFR,and it has a high safety.

Usefulness of dynamic contrast-enhanced MR imaging in the evaluation of pulmonary isolated lesions

Objective： The aim of our study was to investigate the value of dynamic contrast-enhanced MRI for evaluating differential diagnosis of pulmonary isolated lesions. Methods： Twenty-nine consecutive patients enrolled in this study, all of whom underwent DCE-MRI examinations and received a histologic and clinical diagnosis. Among these, lung tuberculoma 7 cases, harmatoma 3 cases, peripheral lung cancer 19 cases. DCE-MRI was acquired with 3D LAVA technique, total 18 phases were acquired, scanner time of per phase was 5-7″. After contrasting agent, twice successive scanning was acquired at 10″ and 50″. Then 1′30″, 2′, 2′30″, 3′, 3′30″, 4′, 5′, 6′, 7′, 8′, 9′, 10′, 11′, 12′ performed scanning. Region of interest was placed on the Maximum level in the tumors. According to Schaefer＇s standard, four types of time signal intensity curve （TIC） were classified, which were A, B, C and D. Compared the dynamic parameters between benign and malignant nodules. Results： Lung tuberculoma may display three curves： A type 1 case, ring-shaped enhancement 4 cases （periphery ring A type, central region D type）, D type 2 cases. Harmatoma may display three curves： A type 1 case, C type 2 case. Peripheral lung cancer may display A type. Except 2 cases D type lung tuberculoma, we compared curve data of 8 cases benign nodules （including tuberculoma Atype and periphery ring Atype, harmatoma Atype and C type） and lung cancer. SlEP%： benign nodules 0.7885 ±0.5543, lung cancer 1.2623 ±0.3059, P 〈 0.05; MER： benign nodules 1.0007 ± 0.4251, lung cancer 1.3694 ±0.2740, P 〈 0.05; washout： P 〉 0.05. Conclusion： Lung MR imaging is helpful to diagnosis and differential diagnosis of isolated benign and malignant nodules. SIEP% and MER could offer valuable information. The evolution of global tuberculosis may be from A type to ring-shaped ennoblement to D type. It was easy to do right diagnosis to lung tuberculoma with ring-shaped ennoblement and D type. Peripheral lung cancer commonly displayed A type and needed identification with acute inflammation. So, it is important to anti-inflammatory follow-up for a few A type nodules.

Correlation of dynamic contrast-enhanced magnetic resonance imaging parameters before colon cancer surgery with the angiogenesis and cell proliferation in tumor lesions

Objective: To discuss the correlation of dynamic contrast-enhanced magnetic resonance imaging parameters before colon cancer surgery with the angiogenesis and cell proliferation in tumor lesions. Methods: A total of 186 patients with colon cancer who were treated in the hospital between January 2015 and January 2017 were collected as colon cancer group;100 patients with multiple polyposis of colon who received colonoscopy in the hospital during the same period were selected as colon polyp group. The differences in DCE-MRI parameters as well as the expression of angiogenesis and cell proliferation genes were compared between the two groups, and Pearson test was used to evaluate the correlation of preoperative DCE-MRI parameters with angiogenesis and cell proliferation gene expression in patients with colon cancer. Results: Preoperative DCE-MRI parameters Ktrans and Kep levels in colon cancer group were significantly higher those in colon polyp group;Cyr61, HIF-α, VEGF, MMP-9, CXCR7, EZH2, SphK1 and IFT57 mRNA expression in lesion tissue of colon cancer group were significantly higher than those of colon polyp group while Kiss-1 mRNA was lower than that of colon polyp group. Pearson test showed that the DCE-MRI parameters Ktrans and Kep levels before colon cancer surgery were directly correlated with the expression of angiogenesis and cell proliferation genes in lesion tissues. Conclusion: Preoperative DCE-MRI parameters can accurately reflect the severity of colon cancer.

Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

Objective/Background: Qualitative assessment of uncertain (type II) time-intensity curves (TICs) in breast DCE-MRI is problematic and operator dependent. The aim of this work is to evaluate if a semi-quantitative assessment of uncertain TICs could improve overall diagnostic performance. Methods: In this study 49 lesions from 44 patients were retrospectively analysed. Per each lesion one region-of-interest (ROI)- averaged TIC was qualitatively evaluated by two radiologists in consensus: all the ROIs resulted in type II (uncertain) TIC. The same TICs were semi-quantitatively re-classified on the basis of the difference between the signal intensities of the last-time-point and of the peak: this difference was classified according to two different cut-off ranges (±5% and ±3%). All patients were cytological or histological biopsy proven. Fisher test and McNemar test were performed to evaluate if results were statistically significant (p < 0.05). Results: Using ±5% cut-off 16 TICs were reclassified as type III and 12 as type I while 21 were reclassified again as type II. Using ±3% 22 TICs were reclassified as type III and 16 as type I while 11 were reclassified again as type II. The semi-quantitative classification was compared to the histological-cytological results: the sensitivity, specificity, positive and negative predictive values obtained with ±3% were 77%, 91%, 91% and 78% respectively while using ±5% were 58%, 96%, 94% and 68% respectively. Using the ±5% cut-off 26/28 (93%) TICs were correctly reclassified while using the ±3% cut-off 34/38 (90%) TICs were correctly reclassified (p < 0.05). Conclusions: Semi-quantitative methods in kinetic curve assessment on DCE-MRI could improve classification of qualitatively uncertain TICs, leading to a more accurate classification of suspicious breast lesions.

Correlation of quantitative perfusion parameters on dynamic contrast-enhanced MRI with prognostic factors and subtypes of breast carcinoma

Objective To investigate whether correlation existsbetween quantitative perfusion parameters obtained from dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and different prognostic factors or immunohistochemical subtypes of breast cancers.Methods A retrospective analysis of DCE-MRI was performed in

动态增强MRI定量参数对HIFU治疗子宫肌瘤的评价

目的探讨动态增强MRI定量参数对高强度聚焦超声(HIFU)治疗子宫肌瘤的疗效。方法将2021年1月—2023年5月在本院使用HIFU治疗的60例子宫肌瘤患者作为研究对象,所有患者均实施动态增强MRI(DCE-MRI)检查,测定各定量参数;根据肌瘤体积消融率分为两组,A组消融≥70%(n=37),B组消融<70%(n=23)。结果HIFU治疗后肌瘤体积明显小于治疗前,Ktrans、Kep、Ve、Vp、BF、BV均低于治疗前,组间差异有统计学意义(P<0.05);A组Ktrans、Kep、Ve、BF、BV均低于B组,组间差异有统计学意义(P<0.05),而两组Vp相当,差异无统计学意义(P>0.05)。结论DCE-MRI定量参数在HIFU治疗子宫肌瘤疗效评价中应用价值较高,能通过各参数评估HIFU疗效,为临床后续治疗提供可靠依据。

Correlation between dynamic contrast-enhanced MRI and histopathology in the measurement of tumor and breast volume and their ratio in breast cancer patients： a prospective study

Background Earlier studies have examined the association between the diameter of primary tumors measured by magnetic resonance imaging （MRI） and histopathology in breast cancer patients. However, the diameter does not completely describe the dimensions of the breast tumor or its volumetric proportion relative to the whole breast. The association between breast tumor volume/breast volume ratios measured by these two techniques has not been reported.

DWI及动态增强MRI定量检测在前列腺癌诊断中的应用

目的:探讨弥散加权成像(DWI)和动态增强MRI(DCE-MRI)定量检测在前列腺良恶性病变鉴别诊断中的价值。方法:回顾性分析15例前列腺DWI和DKtransCE-MRI定量参数,包括表观扩散系数(ADC)、容积转运常数Ktrans、回流速率常数kep、血管外细胞外间隙体积比(ve)值。并运用SPSS进行统计学分析。结果:前列腺癌癌灶和增生灶的ADC、Ktrans和kep值分别为(1.21±0.26)mm2/s和(0.83±0.32)mm2/s、(0.45±0.22)min-1和(0.17±0.08)min-1、(0.95±0.44)min-1和(0.49±0.26)min-1,差异均有统计学意义(P<0.01)。结论:ADC、Ktrans、kep值在前列腺良恶性病变中存在显著不同,DWI和DCE-MRI定量评估对前列腺良恶性病变的鉴别具有一定的价值。

3.0T MRI动态增强曲线半定量分型法对乳腺病变的诊断应用

目的探讨3.0T MRI动态增强曲线半定量分型法对乳腺病变的诊断价值。方法统计分析2012年11月至2014年10月我院收治的女性乳腺疾病患者90例(101个病灶)的临床资料。结果临界值为每秒平均流出斜率的0.03%的动态增强曲线半定量分型对乳腺良恶性病变的诊断水平显著高于0.06%/s、5%、10%(P<0.05);临界值为每秒平均流出斜率的0.03%的动态增强曲线联合ER对乳腺良恶性病变的诊断水平显著高于0.06%/s、5%、10%(P<0.05)。结论3.0T MRI动态增强曲线半定量分型法的对乳腺良恶性病变具有较高的诊断价值,临界值为每秒平均流出斜率的0.03%时对曲线类型进行划分具有显著的优越性,值得在临床推广使用。

MRI动态增强定量分析技术在乳腺癌新辅助化疗疗效评价中的应用研究

目的：探讨MRI动态增强（DCE-MRI）定量分析技术在评价乳腺癌患者新辅助化疗中的应用可行性。方法：选取2013年1月至2015年1月我院收治的乳腺癌患者86例,作为研究对象。所有患者均经穿刺病理活检证实为乳腺浸润性导管癌,所有患者均接受4～6个疗程的新辅助化疗,并于治疗前后行DCE-MRI检查,并于治疗后再次行相同病灶穿刺活检观察有无再次浸润将患者分为无效组（n=32）与缓解组（n=54）,比较两组患者治疗前后各项DCE-MRI相关指标。结果：两组患者化疗前DCE-MRI检查结果中细胞外血管外间隙容积比（Ve）、容量转移常数（Ktrans）、速率常数（Kep）指标比较差异无统计学意义,但治疗后缓解组患者Ktrans、Kep变化量高于无效组,并且Ve水平变化量无效组,P〈0.05,差异有统计学意义;DCE-MRI对缓解组治疗后疗效评估准确率为92.59%,对无效组治疗后疗效评估准确率为90.62%,差异无统计学意义,P〉0.05。结论：DCE-MRI定量分析技术可准确评估乳腺癌患者新辅助化疗的临床疗效,可通过相关增强指标定量评估癌灶浸润与转移,具有临床应用及推广价值。

MRI动态增强定量参数对乳腺非肿块样强化良恶性病变的鉴别诊断价值

目的探讨动态增强磁共振成像(DCE-MRI)定量参数对乳腺非肿块样强化(NME)良恶性病变的鉴别诊断价值。方法选择2014年6月至2015年9月间在东莞市人民医院行DCE-MRI扫描的84例NME患者作为研究对象,所有患者的增强后表现均为乳腺非肿块样强化并经病理学诊断明确其病变性质。根据最终病理学诊断结果分为良性病变组30例和恶性病变组54例,良性病变组又分为乳腺增生组16例和乳腺炎症组14例,恶性病变组又分为导管原位癌组(DCIS,23例)和浸润性导管癌组(IDC,31例)。对比分析良性病变组、恶性病变组以及两组中各亚组的容量转移常数(K^trans)、速率常数(Kep)及血管外细胞外间隙容积比(Ve)等定量参数。以病理结果为金标准,绘制受试者工作特征曲线(ROC)评价各定量参数在诊断NME良恶性病变的诊断效能。结果良性病变组患者的K^trans、Kep、Ve均值分别为(0.070±0.014)/min、(0.490±0.079)/min、0.173±0.034,恶性病变组患者分别为(0.111±0.025)/min、(0.767±0.106)/min、0.168±0.029,两组间K^trans、Kep比较差异均有统计学意义(P<0.05),但两组间的Ve比较差异无统计学意义(P>0.05)。DCIS组及IDC组患者的K^trans、Kep、Ve均值分别为(0.087±0.026)/min、(0.665±0.187)/min、0.142±0.035和(0.147±0.041)/min,(0.838±0.214)/min、(0.152±0.041),两亚组间K^trans、Kep比较差异均有统计学意义(P<0.05),但Ve比较差异无统计学意义(P>0.05);乳腺增生组、乳腺炎症组患者的K^trans、Kep、Ve均值分别为(0.055±0.012)/min、(0.475±0.089)/min、0.179±0.046和(0.107±0.023)/min、(0.503±0.095)/min、0.166±0.038,两亚组间的K^trans比较差异有统计学意义(P<0.05),但Kep、Ve比较差异均无统计学意义(P>0.05);以最大约登指数为最佳诊断切入点,K^trans、Kep、Ve在诊断非肿块强化恶性病变上的AUC分别为0.741、0.767和0.434,三者的敏感性分别为81.48%、79.63%、53.70%,特异性分别为76.67%、83.33%、53.33%,准确性分别为77.38%、80.95%、53.57%,K^trans、Kep的诊断效能比Ve更好,三者在敏感性、特异性和准确性方面比较差异有统计学意义(P<0.05)。结论 DCE-MRI定量参数K^trans、Kep在鉴别诊断NME良恶性病变上具有较高的诊断效能,可作为NME病变定性诊断的可靠指标应用于临床,有望成为无创评价乳腺肿瘤微循环的新方法。

动态增强MRI定量参数在乳腺癌患者中的应用及与乳腺癌分子亚型间的关系

目的探讨动态增强MRI定量参数在乳腺癌患者中的应用及与乳腺癌分子亚型间的关系。方法取2013年11月~2016年12月在我院收治的乳腺癌患者78例作为研究对象,术前利用MRI进行定量参数K^(trans)、K_(ep)和Ve水平测定。利用免疫组织化学法完成ER、PR、HER-2水平检测。结果 68例乳腺癌患者中,Luminal A型23例、Luminal B型20例、HER-2+型12例和TNBC型13例。Luminal A型K_(ep)水平,高于Luminal B型、HER-2+型及TNBC型(P<0.05);Luminal B型K_(ep)水平,高于HER-2+型及TNBC型(P<0.05);ER阳性Kep,低于阴性(P<0.05);PR阳性K^(trans)、K_(ep),低于阴性(P<0.05)。结论利用动态增强MRI能准确的鉴别乳腺癌不同分型,不同分型下乳腺癌中ER、PR表达水平不同。

DCE-MRI定量分析对乳腺癌新辅助化疗疗效评估价值的Meta分析

目的采用Meta分析评价动态增强MRI定量参数在乳腺癌新辅助化疗(NAC)疗效评估中的价值。方法检索Pub Med、PMC、OVID-MEDLINE、中国知网、万方和维普数据库中建库至2016年11月1日公开发表的有关动态增强MRI定量评估乳腺癌NAC疗效的中英文文献,提取文献中MRI定量评估乳腺癌化疗疗效的敏感度与特异度,用Meta-Di Sc1.4软件对评价疗效的敏感度、特异度进行Meta分析,绘制森林图和合并受试者操作特征(SROC)曲线。结果共纳入国内外文献17篇,乳腺癌总病灶数854例,以病理诊断为金标准判断NAC治疗有效255例,治疗无效599例;Meta分析结果显示14篇动态增强MRI定量参数(Ktrans、kep、ve)综合评估乳腺癌NAC疗效的敏感度为83.3%(95%CI:78.3%~87.6%),特异度为82.9%(95%CI:79.5%~85.6%),SROC曲线下面积为89.99%(95%CI:85.70%~94.28%)。4篇单独用容量转移常数(Ktrans)值评估NAC疗效的敏感度、特异度分别为83.6%(95%CI:71.2%~92.2%)、81.6%(95%CI:71.0%~89.5%),SROC曲线下面积为89.99%(95%CI:83.33%~96.65%)。结论动态增强MRI定量参数对乳腺癌NAC疗效的评价具有较高的敏感度和特异度。

MRI动态增强成像联合血清PAI-1、CA27-29对乳腺癌的诊断价值

目的探究MRI动态增强成像(DEC-MRI)联合血清纤溶酶原激活物抑制剂-1(PAI-1)、CA27-29对乳腺癌的诊断价值。方法选取2019年1月至2020年2月于本院乳腺外科就诊的乳腺癌患者90例作为研究对象,另选取年龄相当的同期来本院就诊的乳腺良性肿瘤患者50例作为良性组,所有患者均行DECMRI检查,酶联免疫吸附法(ELISA)检测受试者血清PAI-1、CA27-29水平,受试者工作特征曲线(ROC)分析血清PAI-1、CA27-29水平对乳腺癌的预测价值;Kappa检验分析DEC-MRI及血清PAI-1、CA27-29对乳腺癌诊断结果与病理诊断的一致性;比较DEC-MRI及血清PAI-1、CA27-29与乳腺癌临床病理特征的关系,并分析三者对乳腺癌的诊断价值。结果与良性组相比,乳腺癌组患者病灶DEC-MRI表现为与周围组织分界不清,边缘模糊,强化不均,血清PAI-1、CA27-29水平升高(P﹤0.05);乳腺良性肿瘤病灶表现为与周围组织分界清晰、边缘光滑,强化均匀。ROC分析显示,血清PAI-1、CA27-29预测乳腺癌的截断值分别为25.182 ng/mg、34.373 U/mL。DEC-MRI、血清PAI-1、CA27-29及联合检测诊断乳腺癌结果与病理诊断结果均有中等以上一致性(Kappa=0.799、0.587、0.487、0.835,P﹤0.05)。DEC-MRI及血清PAI-1、CA27-29与肿瘤直径、TNM分期、分类风险及淋巴结转移密切相关(P﹤0.05)。DEC-MRI联合血清PAI-1、CA27-29诊断敏感度显著高于单独诊断(P﹤0.05)。结论血清PAI-1、CA27-29水平升高可能与乳腺癌有关,DEC-MRI扫描联合血清PAI-1、CA27-29可提高乳腺癌诊断灵敏度和准确度,对乳腺癌具有较高预测价值。