动态增强MRI定量参数及最大线性斜率比值对鉴别乳腺良恶性疾病的价值

目的 通过对动态增强MRI时间.信号强度曲线(TIC)的后处理,寻找有效的鉴别诊断良、恶乳腺疾病的定量参数.方法 回顾性分析行MR检查的30例乳腺疾病初诊患者,对动态增强MRI的TIC进行后处理,得出最高信号强度(SImax)、强化峰值(PH)、最大线性斜率(Slope)、最大线性斜率比值(SlopeR)4个定量参数,用独立样本t检验和秩和检验评价4个定量参数在良、恶性病灶间的分布是否具有统计学意义.结果 共17个良性病灶和18个恶性病灶,良性病灶和恶性病灶的SImax值(M值)分别为375.2和158.1,95%可信区间分别为278.2～506.0和160.5～374.8;PH值(M值)分别为114.4和87.8.95%可信区间分别为73.7-196.5和71.3~162.9;Slope值(M值)分别为22.3×10-3和44.0×10-3,95%可信区间分别为13.7×10-3~41.1×10-3和46.1×10-3~81.8×10-3;SlopeR值(M值)分别为2.6和11.4,95%可信区间分别为1.9～3.4和9.8~14.5.SImax、PH值在良、恶性病灶间的分布差异无统计学意义(P值均>0.05);Slope值在良、恶性病灶间的分布差异具有统计学意义(P<0.01),但曲线下面积重叠较大;SlopeR值在良、恶性病灶间的分布差异具有统计学意义(P<0.01),曲线下面积重叠少.结论 SlopeR值对乳腺良、恶性病灶间的鉴别有重要意义.

The value of quantitative parameters of dynamic-enhanced MRI and the significance of the maximum linearity slope ratio in the differential diagnosis of benign and malignant breast lesions

Objective To find the effective quantitative parameters for the differentiation of the breast lesions using the post-processing of time.signal curve of 3D dynamic-enhanced MRI.Methods Thirty patients with 35 lesions underwent 3D dynamic-enhanced MRI and the time-signal cHIve was deduced.The four quantitative parameters including SImax,PH,Slope and SlopeR were analyzed in benign andmalignant lesions of the breast.Independent samples t test and rank sum test were used for the statistics.Results Seyenteen benign lesions and 18 malignant lesions were included in this study.The SImax(M)of benign and malignant lesions were 375.2 and 158.1,the 95% confidence intervals of SImax were 278.2-506.0 and 160.5-374.8.The PH(M)of benign and malignant lesions were 114.4 and 87.8,the 95% confidence intervals of PH were 73.7-196.5 and 71.3-162.9.The Slope(M) of benign and malignant lesions were 22.3×10-3 and 44.0×10-3,the 95% confidence intervals of Slope were 13.7×10-3-41.1×10-3 and 46.1×10-3-81.8×10-3.The Slope"(M) of benign and malignant lesions were 2.6 and11.4,the 95% confidence intervals of SlopeR were 1.9-3.4 and 9.8-14.5.There were no significant differences on SImax and PH between benign and malignant lesions(P>0.05).The significant differences existed on Slope(P<0.01)and SlopeR(P<0.01)between benign and malignant lesions of the breast.Conclusion SlopeR is a very effective parameter in t}le differential diagnosis of breast lesions.