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目的探讨线性参照区域模型DCE-MRI对乳腺良、恶性病变的诊断价值。方法回顾性分析经手术病理或其他方式确诊的32例(32个病灶)乳腺癌和30例(30个病灶)良性病变患者;以良性病变组对侧正常腺体作为正常对照组。所有患者均行3.0 T磁共振定量动态增强扫描,分别测量病灶LRRM模型的容量转移常数(K~(trans))、速率常数(K_(ep))及血管外细胞外间隙容积(Ve)。采用单因素方差分析进行多组间比较,组间两两比较采用LSD法;绘制良恶性病变组K~(trans)、K_(ep)值的ROC曲线,并寻找两者诊断乳腺良、恶性病变的最佳界值。结果正常腺体组、良性病变组及恶性病变组的K~(trans)值分别为(0.224±0.136)min~(-1)、(0.539±0.242)min~(-1)、(1.371±0.709)min~(-1);K_(ep)值分别为(0.115±0.052)min~(-1)、(0.313±0.149)min~(-1)、(0.851±0.425)min~(-1),组间两两比较差异均有统计学意义(P<0.05);正常腺体组、良性病变组及恶性病变组的Ve值分别为0.186±0.096、0.240±0.175、0.212±0.140;多组间比较无差异(P﹥0.05)。良恶性病变间K~(trans)值及K_(ep)值ROC曲线下面积分别为0.905及0.936;最佳诊断界值分别为0.786 min~(-1)及0.410 min~(-1);诊断的敏感性分别为81.3%及93.8%,特异性分别为80.0%及83.3%。结论 LRRM模型DCE-MRI所测得K~(trans)、K_(ep)值稳定;K~(trans)、K_(ep)值对乳腺良、恶性病变的诊断有着较高的价值。LRRM模型DCE-MRI是一种有效的定量检查方法。
Objective To investigate the diagnostic value of linear reference area model DCE-MRI in benign and malignant breast lesions. Methods Thirty-two cases of breast cancer and 30 cases of benign lesion confirmed by surgery or other methods were retrospectively analyzed. The contralateral normal gland was used as normal control group in benign lesion group. All patients underwent 3.0 T magnetic resonance quantitative dynamic contrast-enhanced scan. The volume transfer constant (K trans), rate constant (K ep) and extracellular extracellular space volume (Ve) of LRRM were measured. One-way analysis of variance (ANOVA) was used to compare the multiple groups and LSD was used to compare the pairwise comparisons between groups. The ROC curves of K trans and K ep values of the benign and malignant lesions were plotted, and both of them were diagnosed as benign and malignant breast lesions The best cut-off value. Results The K values of normal gland group, benign lesion group and malignant lesion group were (0.224 ± 0.136) min ~ (-1), (0.539 ± 0.242) min ~ (-1), (1.371 ± 0.709 (0.1151 ± 0.052) min ~ (-1), (0.313 ± 0.149) min ~ (-1) and (0.851 ± 0.425) min ~ (-1) (P <0.05). The Ve values of normal gland group, benign lesion group and malignant lesion group were 0.186 ± 0.096,0.240 ± 0.175,0.212 ± 0.140, No difference (P> 0.05). The area under the ROC curve of K trans and K ep values of benign and malignant lesions were 0.905 and 0.936, respectively. The best diagnostic values were 0.786 min -1 and 0.410 min -1 respectively. The sensitivity was 81.3% and 93.8% respectively, and the specificity was 80.0% and 83.3% respectively. Conclusion The K trans and K ep values measured by DCE-MRI in LRRM model are stable. K trans and K ep values are of great value in the diagnosis of benign and malignant breast lesions. LRRM model DCE-MRI is an effective quantitative test.