IVIM定量分析在不同分子分型乳腺癌鉴别诊断中的效果分析

doi:10.7517/issn.1674-0475.191018

摘要/Abstract

摘要： 探讨采用IVIM-DWI技术定量分析在鉴别不同分子亚型乳腺癌中的应用价值。回顾性分析2016年7月~2019年3月我院住院治疗的121例乳腺癌患者和32例乳腺良性肿块患者的临床资料，所有患者均接受MRI评估、进行IVIM-DWI成像，并获得ADC值和IVIM-DWI多参数值；分析良恶性乳腺肿块之间ADC及IVIM-DWI多参数值的差异；比较不同分子亚型乳腺癌之间ADC及IVIM-DWI多参数值的定量检测情况。结果发现，（1）ROC曲线显示，在鉴别良恶性乳腺肿块方面，D值曲线下面积大于ADC、D^*和f（P<0.05）；4项指标联合预测的曲线下面积显著高于4种指标单独预测（P<0.05）；（2）ER和PR阴性组肿瘤组织中的D值低于阳性组，D^*值高于阳性组（P<0.05）；Ki67<14%组，肿瘤组织中的ADC值和D值高于Ki67 ≥ 14%组，D^*值低于Ki67 ≥ 14%组（P<0.05）；肿瘤组织中的f值，HER-2阳性组高于HER-2阴性组（P<0.05）；（3）不同分型乳腺癌之间ADC值、D值、D^*值及f值存在差异，其中三阴性乳腺癌组呈现较低的ADC值、D值和较高的f值（P<0.05）。IVIM是一种有价值的磁共振技术，可用于鉴别良恶性乳腺肿块，区分乳腺癌分子亚型。通过IVIM参数了解乳腺癌特征为临床提供了一种准确评估乳腺癌的新方法。

关键词: 体素内不相干运动扩散加权成像, 乳腺癌, 分子亚型, 鉴别诊断

Abstract: To evaluate the application value of IVIM-DWI in differentiating different molecular subtypes of breast cancer. The clinical data of 121 patients with breast cancer who were hospitalized in our hospital from July 2016 to March 2019,and 32 patients with benign breast masses were retrospectively analyzed. All patients underwent MRI assessment and IVIM-DWI imaging. The ADC value and the IVIM-DWI multi-parameter values were obtained.The quantitative detection of ADC and IVIM-DWI multiple parameter values among different molecular subtypes of breast cancer was compared. (1) The ROC curve shows that in the identification of benign and malignant breast lumps, The area under the curve of D value is larger than ADC, D^* and f (P<0.05); The area under the curve predicted by the four indexes was significantly higher than that predicted by the four indexes alone (P<0.05).(2) The D value in the tumor tissues of the ER and PR negative groups was lower than that of the positive group, and the D^* value was higher than that of the positive group (P<0.05). The ADC value and D value in the tumor tissues of Ki67<14% group were higher than those in Ki67 ≥ 14% group, and the D^* value was lower than that in Ki67 ≥ 14% group (P<0.05); In the HER-2 positive group tumor, the f value in the tissue was higher than that in the HER-2 negative group (P<0.05); (3) There were differences in ADC value, D value, D^* value and f value between different types of breast cancer, among which the three negative breast cancer group showed lower ADC value, D value and higher f value (P<0.05). IVIM is a valuable magnetic resonance technique that can be used to identify benign and malignant breast masses and to differentiate breast cancer molecular subtypes. Understanding the characteristics of breast cancer through IVIM parameters provides a new way to accurately assess breast cancer.

Key words: intravoxel incoherent motion diffusion-weighted imaging, breast cancer, molecular subtype, differential diagnosis

中图分类号:

汪林, 陈向荣, 许淑惠, 连涛, 林钱森, 余梅英. IVIM定量分析在不同分子分型乳腺癌鉴别诊断中的效果分析[J]. 影像科学与光化学, 2020, 38(2): 368-375.

WANG Lin, CHEN Xiangrong, XU Shuhui, LIAN Tao, LIN Qiansen, YU Meiying. Analysis of the Effect of IVIM Quantitative Analysis on Differential Diagnosis of Different Molecular Types of Breast Cancer[J]. Imaging Science and Photochemistry, 2020, 38(2): 368-375.

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