摘要
目的:探讨体素内不相干运动(IVIM)成像联合扩散峰度成像(DKI)对乳腺癌分子分型的诊断价值。方法:选取经病理证实的乳腺癌患者244例,分为4个分子亚型(Luminal A型、Luminal B型、HER-2阳性型和三阴型),均行IVIM及DKI检查。分析不同分子分型乳腺癌的临床资料和真实扩散系数(D)、灌注相关扩散系数(D^(*))、灌注分数(f)、平均扩散峰度值(MK)和平均扩散率(MD),绘制ROC曲线比较其诊断效能。结果:244例中,Luminal A型32例,Luminal B型131例,HER-2阳性型36例,三阴型45例。Luminal A型的D^(*)值均小于其他分子分型(均P<0.01);三阴型的f值均高于其他分子分型(均P<0.01);Luminal B型的MD值小于HER-2阳性型及三阴型,而MK值大于HER-2阳性型及三阴型(均P<0.05)。D、D^(*)、f、MD及MK值对鉴别Luminal A/B型与非Luminal型有价值,其中IVIM成像的D^(*)值及DKI的MD值ROC曲线的AUC较大;且将IVIM成像与DKI联合后,AUC为0.752,诊断效能高于单一参数(Z=1.845~4.144,P=0.001~0.045)。D、D^(*)、MD及MK值对HER-2阳性型与非HER-2型有鉴别价值,其中IVIM成像的D值及DKI的MD值的AUC较大。D^(*)、f及MD值对鉴别三阴型与非三阴型有价值,三者联合后敏感度与准确度均高于单一参数。结论:IVIM成像联合DKI可用于乳腺癌分子分型的预测,有利于患者的个体化治疗。
Objective:To assess the predictive value of intravoxel incoherent motion(IVIM)and diffusion kurtosis imaging(DKI)in determining molecular subtypes expression in breast cancer.Methods:A total of 244 patients of breast cancer confirmed by pathology were collected,and they were divided into 4 molecular subtypes,Luminal A type,Luminal B type,HER-2-positive type and triple-negative type.IVIM and DKI scanning were performed in all patients.The values of true diffusion coefficient(D),perfusion-related diffusion coefficient(D^(*)),perfusion fraction(f),mean kurtosis(MK)and mean diffusivity(MD)were analyzed.The ROC curve was drawn to compare the diagnostic efficiency.Results:Among the 244 cases,32 cases were Luminal A type,131 cases were Luminal B type,36 cases were HER-2-positive type and 45 cases were triple-negative type.The D^(*)value of Luminal A type was lower than that of the other three types(P<0.01).The f value of triple-negative type was higher than that of the other three types(P<0.01).Luminal B type had a lower MD value and a higher MK value than the HER-2-positive type and triple-negative type(all P<0.05).The D,D^(*),f,MD and MK values were more valuable for distinguishing between Luminal A/B type and non-Luminal type,and the D^(*)and MD values had the larger AUCs.Combining the IVIM and DKI models,the AUC was 0.752,the diagnostic efficacy was higher than that of a single parameter(Z=1.845~4.144,P=0.001~0.045).The D,D^(*),MD and MK values were valuable for identifying HER-2-positive type and other molecular subtypes,and the D and MD values had the large AUCs.The D^(*),f and MD values were valuable for identifying triple-negative type and non-triple-negative type,and the sensitivity and accuracy of the combined three parameters were higher than those of a single parameter.Conclusion:IVIM combined with DKI can be used to predict the molecular subtype in breast cancer,which is beneficial for the individualized treatment.
作者
尹思远
邵凯
王唯伟
YIN Siyuan;SHAO Kai;WANG Weiwei(Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,China)
出处
《中国中西医结合影像学杂志》
2024年第1期85-89,共5页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
山东省中医药科技项目(Q-2022132)
山东省医药卫生科技发展计划项目(202109010447)
济医附院医学英才培养计划项目(2022-yxyc-010)。
关键词
乳腺肿瘤
磁共振成像
体素内不相干运动
扩散峰度成像
Breast neoplasms
Magnetic resonance imaging
Intravoxel incoherent motion
Diffusion kurtosis imaging
作者简介
通信作者:王唯伟,Email:1027070940@qq.com。
