多参数磁共振在乳腺非肿块性强化病变病理性质及分子亚型中评估作用探究

doi:10.3969/j.issn.1006-6233.2022.10.028

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1692 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨多参数磁共振在乳腺非肿块性强化(NME)病变病理性质及分子亚型中评估作用。方法: 选取2018年1月至2021年12月258例NME患者,均行多参数磁共振检查,包括平扫3D扰相快速梯度回波T1WI横轴位、脂肪抑制T2WI横轴位、动态增强磁共振成像(DCE-MRI)、弥散加权成像(DWI)扫描,根据病理结果分为恶性组(n=168)、良性组(n=90),比较两组基线资料、多参数磁共振检测结果,采用受试者工作特征曲线(Receiver operating characteristic,ROC)分析多参数磁共振鉴别恶性NME价值,并比较不同分子亚型患者多参数磁共振检测结果。结果: 恶性组内部强化簇状、节段样分布、瘤周水肿患者多于良性组,ADC值低于良性组(P<0.05);经ROC曲线显示,内部强化簇状、节段样分布、ADC值、瘤周水肿联合诊断AUC大于任一单一参数;HER-2型ADC值高于Luminal A型、Luminal B型、TNBC型(P<0.05);HER-2型、TNBC型瘤周水肿患者多于Luminal A型、Luminal B型(P<0.05)。结论: 内部强化簇状、节段样分布、ADC值、瘤周水肿对于NME病变病理性质具有较高诊断价值,临床可通过联合诊断鉴别其良恶性及分子亚型评估,为临床制定治疗方案提供参考依据。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	秦小雪
	席佳佳
	徐佳

关键词 ：磁共振, 多参数, 乳腺病变, 分子亚型

Abstract：Objective: To investigate the role of multiparametric MRI in the assessment of the pathological nature and molecular subtypes of non-mass-enhancing (NME) lesions of the breast. Methods: Twenty eight patients with NME admitted from January 2018 to December 2021 were selected and all underwent multiparametric MRI,including flat-scan 3D scrambled-phase fast gradient echo T1WI transaxial position,fat-suppressed T2WI transaxial position,dynamic enhanced magnetic resonance imaging (DCE-MRI),and diffusion-weighted imaging (DWI) scans.The patients were divided into malignant group (n=168) and benign group according to pathological findings.The baseline data and multiparametric MRI results of the two groups were compared,the value of multiparametric MRI in identifying malignant NME was analyzed using the receiver operating characteristic (ROC) curve,and the results of multiparametric MRI in patients with different molecular subtypes were compared. Results: In the malignant group,there were more patients with internal reinforcement clusters,segmental distribution and perineural oedema than in the benign group,and the ADC values were lower than in the benign group (P<0.05); the ROC curve showed that the combined diagnostic AUC of internal reinforcement clusters,segmental distribution,ADC values and perineural oedema was greater than that of any single parameter; the ADC values of HER-2 type were higher than those of Luminal A,Luminal B and TNBC types (P<0.05); the ADC values of HER-2 and TNBC types were higher than those of Luminal A and TNBC types (P<0.05).(P<0.05); more patients with HER-2 and TNBC types had peri-tumoural oedema than Luminal A and Luminal B types (P<0.05). Conclusion: Internal enhancement clusters,segmental distribution,ADC values and peri-tumoural oedema are of high diagnostic value for the pathological nature of NME lesions and can be used clinically to identify their benign and malignant nature and to assess their molecular subtypes,providing a reference basis for clinical treatment planning.

Key words： Magnetic resonance Multiparametric Breast lesions Molecular subtypes

基金资助:江苏省优势学科建设工程项目,(编号:YSHL0815-77)

通讯作者: 徐佳

引用本文:

秦小雪, 席佳佳, 徐佳. 多参数磁共振在乳腺非肿块性强化病变病理性质及分子亚型中评估作用探究[J]. 河北医学, 2022, 28(10): 1731-1737.
QIN Xiaoxue, XI Jiajia, XU Jia. The Role of Multiparametric Magnetic Resonance in the Assessment of the Pathological Nature and Molecular Subtypes of Non-Mass-Enhancing Lesions in the Breast. HeBei Med, 2022, 28(10): 1731-1737.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.10.028 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I10/1731

[1] Kang W,Zhong W,Su D.The cone-beam breast computed tomography characteristics of breast non-mass enhancement lesions[J].Acta Radiol,2021,62(10):1298-1308.
[2] Tan Y,Mai H,Huang Z,et al.Additive value of texture analysis based on breast MRI for distinguishing between benign and malignant non-mass enhancement in premenopausal women[J].BMC Med Imaging,2021,21(1):48.
[3] 赵婷,蒋世亮.乳腺钼靶,超声造影检查鉴别诊断乳腺非肿块样强化病变的良恶性质的对比分析[J].影像科学与光化学,2021,39(4):512-516.
[4] 吕以东,陈艳,韩义娜,等.动态增强磁共振成像联合表观弥散系数值在乳腺BI-RADS 4类非肿块样病变良恶性鉴别中的价值[J].山西医药杂志,2020,49(22):3075-3077.
[5] Avendano D,Marino MA,Leithner D,et al.Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI[J].Breast Cancer Res,2019,21(1):136.
[6] Kuhl CK,Mielcareck P,Klaschik S,et al.Dynamic breast MR Imaging:are signal intensity time course data usemful for differential diagnosis of enhancing lesion[J].Radiology,1992,11(1):101-110.
[7] Goldhirsch A,WIiner E P,Coates A S,et al.Personalizing the treatment of women with early breast cancer:highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013[J].Ann Oncol,2013,24(9):2206- 2223.
[8] 刘靓,朱丹,沈晶,等.多模态MRI技术在乳腺非肿块性强化病变良恶性鉴别中的临床研究[J].中国临床医学影像杂志,2020,31(1):15-19.
[9] 戴丽娟,时高峰,杨丽,等.MRI检查联合钼钯检查诊断非肿块型乳腺癌的临床价值研究[J].中国全科医学,2019,22(30):3683-3688.
[10] 宋超,朱望舒,石思雅,等.定量DCE-MRI对乳腺非肿块型强化病变良恶性的预测价值[J].放射学实践,2020,35(2):190-196.
[11] Goto M,Sakai K,Yokota H,et al.Diagnostic performance of initial enhancement analysis using ultra-fast dynamic contrast-enhanced MRI for breast lesions[J].Eur Radiol,2019,29(3):1164-1174.
[12] 李艳玲,李洁,曹崑,等.乳腺癌动态增强MRI特征:非肿块样强化与肿块样强化的比较[J].中国医学影像技术,2010,26(7):1258-1261.
[13] 马德晶,逯峰,邹雪雪,等.IVIM-DWI辅助DCE-MRI对良,恶性乳腺非肿块样强化病变的鉴别诊断价值[J].放射学实践,2019,34(12):1337-1342.
[14] Tao WJ,Zhang HX,Zhang LM,et al.Combined application of pharamcokinetic DCE-MRI and IVIM-DWI could improve detection efficiency in early diagnosis of ductal carcinoma in situ[J].Appl Clin Med Phys,2019,20(7):142-150.
[15] 于洪伟,闫燃,王武.乳腺MRI动态增强对非肿块样强化病灶的诊断与鉴别诊断价值[J].实用放射学杂志,2013,29(11):1770-1773.