【摘要】 目的 观察动态增强核磁共振成像(DCEMRI)参数在乳腺癌早期诊断及预后评估中的应用效果。方法 选取2019年5月至2020年5月期间乳腺癌患者96例及乳腺良性病变者50例,分别纳入乳腺癌组、良性病变组,均行DCE-MRI检查,获得时间-信号强度曲线(TIC)及定量参数,比较两组TIC曲线类型及定量参数检测值,乳腺癌组患者根据治疗结束后为期2年的随访结果分为生存组、死亡组,比较两组DCE-MRI定量参数,采用受试者工作特征(ROC)曲线评估DCE-MRI定量参数对乳腺癌患者预后的预测价值。结果 两组TIC曲线类型差异有统计学意义,乳腺癌组Ⅲ型曲线占比高于良性病变组,Ⅰ型曲线占比低于良性病变组(P<0.05);乳腺癌组Kep、Ktrans、Ve均大于良性病变组(P<0.05);死亡组Kep、Ktrans、Ve均大于生存组(P<0.05);ROC曲线显示,Kep、Ktrans、Ve单独及联合预测乳腺癌患者不良预后的敏感度/特异度分别为80.00%/67.40%、80.0 0%/87.90%、50.00%/83.70%、90.00%/76.70%,对应的AUC分别为0.748、0.869、0.750、0.931。结论 DCE-MRI定量参数对乳腺良恶性病变的鉴别及乳腺癌的预后评估中具有重要价值。更多还原

【Abstract】 Objective To observe the application effects of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) parameters in the early diagnosis and prognosis evaluation of breast cancer. Methods From May 2019 to May 2020, 96 patients with breast cancer and 50 patients with benign breast lesions were selected, and they were included in breast cancer group and benign lesion group respectively. Both groups underwent DCE-MRI examination to obtain the time-signal intensity curve(TIC) and quantitative parameters [rate constant(Kep), volume transfer constant(Ktrans), extravascular extracellular volume fraction(Ve)]. The TIC curve types and detection values of quantitative parameters were compared between the two groups. The patients with breast cancer were divided into survival group and death group according to the 2-year follow-up results after the end of treatment, and the quantitative parameters of DCE-MRI were compared, and receiver operating characteristic(ROC) curve was used to evaluate the predictive value of DCE-MRI quantitative parameters on the prognosis of patients with breast cancer. Results There were statistically significant differences in the types of TIC curves between the two groups, and the proportion of type Ⅲ curve in breast cancer group was higher than that in benign lesion group while the proportion of type I curve was lower than that in benign lesion group(P<0.05). Kep, Ktrans and Ve were higher in breast cancer group than those in benign lesion group(P<0.05), and were higher in death group than those in survival group(P<0.05). ROC curve showed that the sensitivities/specificities of Kep, Ktrans and Ve alone or in combination on predicting the poor prognosis of patients with breast cancer were 80.00%/67.40%, 80.00%/87.90%, 50.00%/83.70%, 90.00%/76.70%, and the corresponding AUCs were 0.748, 0.869, 0.750 and 0.931 respectively. Conclusion DCE-MRI quantitative parameters have important value in the identification of benign and malignant breast lesions and the prognosis evaluation of breast cancer.更多还原