| 曹崑,赵博,李艳玲,曲玉虹,李晓婷,孙应实.MRI增强早期及晚期全肿瘤直方图分析诊断肿块型乳腺癌新辅助化疗后残余癌[J].中国医学影像技术,2019,35(4):484~487 |
| MRI增强早期及晚期全肿瘤直方图分析诊断肿块型乳腺癌新辅助化疗后残余癌 |
| Whole tumor histogram analysis of early and late phase contrast-enhanced MRI in predicting residuals after neoadjuvant chemotherapy for mass-like breast cancer |
| 投稿时间：2019-01-10 修订日期：2019-03-08 |
| DOI：10.13929/j.1003-3289.201901013 |
| 中文关键词: 乳腺肿瘤 磁共振成像 肿瘤辅助疗法 肿瘤,残余 直方图 |
| 英文关键词:breast neoplasms magnetic resonance imaging neoadjuvant therapy neoplasm, residual histogram |
| 基金项目:国家重点研发计划"重大慢性非传染性疾病防控研究"专项（2017YFC1309100）。 |
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| 中文摘要: |
| 目的 探讨MR增强早期及晚期全肿瘤直方图分析诊断肿块型乳腺癌新辅助化疗（NAC）后残余癌的价值。方法 选取肿块型乳腺癌患者52例，于NAC后行MR增强扫描，在增强早期减影图像上确定是否存在残余强化灶，并勾画全肿瘤ROI。根据病理结果，将原肿瘤部位存在强化灶者分为残余癌组（n=29）和非残余癌组（n=9），比较2组间直方图参数，分析残余癌的影响因素，以ROC曲线分析直方图参数诊断残余癌的效能。结果 残余癌组与非残余癌组间残余强化灶体积、增强早期信号强度最大值（Mx）、增强晚期峰度值差异均有统计学意义（P均<0.05）。Logistic回归分析结果显示，增强晚期峰度值是残余癌的独立影响因素。将增强晚期峰度值（界值为2.25）作为影像学诊断残余癌的标准，其诊断特异度为76.19%（16/21），敏感度90.32%（28/31），准确率84.62%（44/52）。结论 MR增强早期及晚期全肿瘤直方图分析能够反映肿块型乳腺癌病灶内部信号分布；增强晚期峰度值可用于诊断NAC后残余癌。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of whole tumor histogram analysis of early and late phase contrast-enhanced MRI in predicting residual tumor after neoadjuvant chemotherapy (NAC) for mass-like breast cancer. Methods Totally 52 patients with mass-like breast cancer underwent contrast-enhanced MR scanning after NAC. ROIs were drawn on early phase images to cover the whole enhanced areas. Patients with enhanced signals on site of original tumor were divided into residual group (n=29) and non-residual group (n=9) according to pathological results. Parameters of histogram were compared between the 2 groups, and Logistic regression was used to analyze the impact factors of residual tumors, then diagnostic value of histogram parameters to residual tumors was assessed with ROC curves. Results There were significant differences in volume of enhanced areas, maximal signal intensity on early phase and kurtosis on late phase between residual group and non-residual group (all P<0.05). Logistic regression analysis showed that kurtosis on late phase was an independent factor of residual tumor (P=0.025, OR=4.303, 95%CI). The diagnosis cutoff value of kurtosis on late phase was 2.25, the diagnostic specificity, sensitivity and accuracy rate were 76.19%(16/21), 90.32%(28/31) and 84.62%(44/52), respectively. Conclusion Histogram analysis is a useful method to reflect the internal distribution of signal intensities on early and late enhanced phases. Kurtosis on late phase is an independent factor for diagnosis of residuals after NAC for mass-like breast cancer. |
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