發(fā)布時(shí)間：2018-03-08 11:15

  本文選題：乳腺癌　切入點(diǎn)：磁共振成像　出處：《臨床放射學(xué)雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的探討基于動(dòng)態(tài)增強(qiáng)磁共振成像(DCE-MRI)及特定藥物動(dòng)力學(xué)模型所獲得的量化參數(shù)與乳腺癌組織病理相關(guān)性。方法搜集61例乳腺癌患者DCE-MRI資料,通過(guò)后處理軟件生成如下量化參數(shù),定量參數(shù):轉(zhuǎn)移常數(shù)(K~(trans))、速率常數(shù)(K_(ep))、血漿分?jǐn)?shù)(V_p);半定量參數(shù):(1)增強(qiáng)掃描病灶達(dá)峰時(shí)間(TTP);(2)增強(qiáng)掃描病灶內(nèi)對(duì)比劑最大濃度值(MAX Conc);(3)增強(qiáng)掃描時(shí)間信號(hào)曲線下面積(AUC);(4)增強(qiáng)掃描時(shí)間信號(hào)曲線最大斜率值(MAX Slope)。所有患者M(jìn)RI檢查后1周內(nèi)經(jīng)手術(shù)或穿刺活檢取得病理結(jié)果。采用Kruskal-Wallis檢驗(yàn)及Mann-Whitney U檢驗(yàn)兩兩比較導(dǎo)管內(nèi)癌組,非特殊類型浸潤(rùn)性癌組及特殊類型癌組間各量化參數(shù)的差異。采用Mann-Whitney U檢驗(yàn)分析低組織學(xué)分級(jí)組(包括Ⅰ級(jí)和Ⅱ級(jí))和高組織學(xué)分級(jí)組(Ⅲ級(jí))、有淋巴結(jié)轉(zhuǎn)移組和無(wú)淋巴結(jié)轉(zhuǎn)移組間各量化參數(shù)的差異。結(jié)果 61例乳腺癌分為導(dǎo)管內(nèi)癌組8例,非特殊類型浸潤(rùn)性癌組48例,特殊類型癌組5例。導(dǎo)管內(nèi)癌組量化參數(shù)值K~(trans) Max=0.651(0.209 min~(-1))、K_(ep) Max=0.865(0.198)min~(-1)、K_(ep) Mean=0.270(0.021)min~(-1)明顯小于特殊類型癌組量化參數(shù)值K~(trans) Max=1.390(0.846)min~(-1)、K_(ep)Max=2.169(1.122)min~(-1)、K_(ep)Mean=0.512(0.449 min~(-1)),P值分別為0.025、0.020、0.038。非特殊類型浸潤(rùn)性癌組量化參數(shù)Ktrans Max=0.740(0.078)min~(-1)、K_(ep)Mean=0.235(0.023)min~(-1)及MAX Conc Max=0.188(0.013)小于特殊類型癌組間量化參數(shù)K~(trans) Max=1.390(0.846)min~(-1)、K_(ep) Mean=0.512(0.449)min~(~(-1))及MAX Conc Max=0.385(0.238),P值分別為0.043、0.025、0.036。非特殊類型浸潤(rùn)性癌組根據(jù)組織學(xué)分級(jí),分為低組織學(xué)分級(jí)組(包括Ⅰ級(jí)和Ⅱ級(jí))34例,高組織學(xué)分級(jí)組(Ⅲ級(jí))12例。根據(jù)淋巴結(jié)轉(zhuǎn)移狀態(tài),分為無(wú)淋巴結(jié)轉(zhuǎn)移組37例,有淋巴結(jié)轉(zhuǎn)移組24例,結(jié)果顯示較低分化組與高分化組、無(wú)淋巴結(jié)轉(zhuǎn)移組與有淋巴結(jié)轉(zhuǎn)移組間各量化參數(shù)間差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論基于DCE-MRI技術(shù)及特定的藥物動(dòng)力學(xué)模型所獲得的部分量化參數(shù)在乳腺癌不同病理類型間存在差異。
[Abstract]:Objective to investigate the correlation between the quantitative parameters obtained from dynamic enhanced magnetic resonance imaging (DCE-MRI) and specific pharmacokinetic models and the histopathology of breast cancer. Methods the DCE-MRI data of 61 patients with breast cancer were collected and the following quantitative parameters were generated by post-processing software. Quantitative parameters: transfer constant (K), rate constant (K), plasma fraction (V / P); semi-quantitative parameter (1) enhancement of peak time (TTP) / 2) enhancement of maximum concentration of contrast-medium in the lesion (Max Concor)) enhancement of the area under the scanning time signal curve and enhancement of the area under the scanning time signal curve (AUC ~ (4)). The maximum slope value of scanning time signal curve was Max Slope.The pathological results of all patients were obtained by operation or puncture biopsy within one week after MRI examination. Kruskal-Wallis test and Mann-Whitney U test were used to compare intraductal carcinoma group. Mann-Whitney U test was used to analyze the difference of quantitative parameters between non-special type invasive carcinoma group and special type carcinoma group. The low histological grade group (including grade 鈪，

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