發(fā)布時(shí)間：2018-06-11 12:03

  本文選題：乳腺腫瘤 + 磁共振成像��； 參考：《中國(guó)癌癥雜志》2017年10期

【摘要】：背景與目的:乳腺癌是女性最常見(jiàn)的惡性腫瘤,體素內(nèi)不相干運(yùn)動(dòng)(intravoxel incoherent motion,IVIM)是近年來(lái)發(fā)展的基于雙指數(shù)計(jì)算模型的功能成像方法,可反映單純擴(kuò)散和灌注兩種效應(yīng)。該研究旨在探討IVIM各參數(shù)的可重復(fù)性及鑒別診斷乳腺良惡性病變的價(jià)值,與定量動(dòng)態(tài)增強(qiáng)MRI(dynamic contrast enhanced-magnetic resonance imaging,DCE-MRI)比較,并探討兩種成像方法灌注參數(shù)的相關(guān)性。方法:收集發(fā)現(xiàn)乳腺占位性病變并獲得術(shù)后明確病理結(jié)果的患者56例,共61個(gè)病灶,其中良性病變30個(gè),惡性病變31個(gè)�；颊咝g(shù)前均行IVIM及DCE-MRI檢查。2名放射科醫(yī)師獨(dú)立對(duì)圖像進(jìn)行后處理,獲得IVIM參數(shù)(D、D~*、f值),DCE-MRI參數(shù)(K~(trans)、K_(ep)、V_e值)。采用組內(nèi)相關(guān)系數(shù)(intraclass correlation coefficients,ICC)檢測(cè)2名醫(yī)師IVIM測(cè)量值的一致性;采用獨(dú)立樣本t檢驗(yàn)比較乳腺良惡性病變各參數(shù)值的差異;對(duì)于差異有統(tǒng)計(jì)學(xué)意義的參數(shù)采用受試者工作特征(receiver operating characteristic,ROC)曲線評(píng)價(jià)其鑒別診斷乳腺良惡性病變的效能;采用Pearson相關(guān)分析比較IVIM灌注相關(guān)參數(shù)與DCE-MRI的相關(guān)性。結(jié)果:2名醫(yī)師IVIM測(cè)量值的組內(nèi)、組間重復(fù)性均較好(ICC≥0.730,P均0.05)。乳腺惡性病變的D值低于良性病變,而f、K~(trans)及K_(ep)值高于良性病變,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),D~*、V_e值差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。D、f、K~(trans)、K_(ep)值鑒別診斷乳腺良惡性病變的ROC下面積分別為0.896、0.677、0.796、0.847。D與K~(trans)、K_(ep)的ROC下面積差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。以1.07×10~(-3) mm~2/s為診斷閾值,D值特異度最高(86.67%),以0.54/min為診斷閾值,K_(ep)值的靈敏度最高(98.36%)。相關(guān)分析顯示f與K~(trans)、K_(ep)值及D~*與K~(trans)值均呈弱正相關(guān),相關(guān)系數(shù)r分別為0.373、0.360和0.294(P?均0.05)。結(jié)論:IVIM參數(shù)在不同醫(yī)師分析中重復(fù)性較好,IVIM與DCE-MRI均有助于鑒別診斷乳腺良惡性病變,兩種成像方法在反映組織灌注情況中存在相關(guān)性。
[Abstract]:Background & objective: breast cancer is the most common malignant tumor in women. Intra voxel incoherent motionIVIMA is a new functional imaging method developed in recent years, which can reflect both diffusion and perfusion effects. The purpose of this study was to investigate the reproducibility of contrast enhanced-magnetic resonance parameters and the value of differentiating benign and malignant breast lesions, and to compare them with quantitative dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI), and to explore the correlation between the perfusion parameters of the two imaging methods. Methods: a total of 61 lesions including 30 benign lesions and 31 malignant lesions were collected. All the patients underwent IVIM and DCE-MRI examination before operation. 2 radiologists independently processed the images. The parameters of IVIM and DCE-MRI parameters were obtained. The consistency of two physicians was measured by intraclass correlation coefficients, and the difference of parameters between benign and malignant breast lesions was compared by independent sample t-test. The effectiveness of differential diagnosis of benign and malignant breast lesions was evaluated by receiver operating characteristic ROCcurve, and the correlation between perfusion parameters and DCE-MRI was compared by Pearson correlation analysis. Results the reproducibility of IVIM measured by two physicians was better than that of the control group (ICC 鈮，

本文編號(hào)：2005143