龚俊峰;李晓燕;王永杰;

• 1:上海交通大学医学院附属新华医院崇明分院医学影像科

摘要(Abstract)：

目的探讨对比增强能谱乳腺X线成像(contrast enhanced energy spectrum mammography,CESM)、动态增强磁共振成像(dynamiccontrast-enhancedMRI,DCEMRI)联合扩散加权成像(diffusionweightedimaging,DWI)评估不同乳腺癌分子分型的价值。材料与方法选择2017年1月至2020年2月我院收治并确诊的162例乳腺癌患者,根据其分子分型分为Luminal A型组(n=41)、Luminal B型组(n=69)、Her-2过表达型组(n=32)、三阴性型组(n=20),均行CESM、DCE-MRI、DWI检查,比较4组CESM影像特点及流入率(wash in rate,WIR)、最大强化程度(maximum enhancement,ME)、达峰时间(time to peak,TTP)、ADC值,采用Spearman相关分析CESM影像特点与乳腺癌分子分型的相关性,采用ROC曲线对MRI相关参数评估乳腺癌分子分型的价值进行分析。结果 4组钙化特点无显著差异(P>0.05);4组肿块直径、肿块形态、肿块边界、强化、腋下淋巴结肿大特点及ME、TTP、WIR、ADC有显著差异(P<0.05);钙化与乳腺癌分子分型无相关性(P>0.05);肿块直径、肿块形态、肿块边界、强化、腋下淋巴结肿大与乳腺癌分子分型具有显著相关性(P<0.05);WIR联合ADC评估三阴性型乳腺癌的AUC为0.898(95%CI:0.846～0.950),准确性为82.65%,cut-off值为0.653;ME评估Luminal B型乳腺癌的AUC为0.678(95%CI:0.591～0.765),准确性为72.10%,cut-off值为0.442;TTP评估Her-2过表达型乳腺癌的AUC为0.773(95%CI:0.691～0.855),准确性为73.45%,cut-off值为0.469。结论 CESM、MRI动态增强联合DWI对乳腺癌分子分型的判断有一定指导意义,有望应用于评估乳腺癌分子分型。

关键词(KeyWords)： 乳腺X线摄影;磁共振成像;对比增强;动态增强;扩散加权成像;乳腺癌;分子分型;评估价值

Abstract:

Keywords:

基金项目(Foundation): 上海交通大学附属新华医院崇明分院院级课题(编号：2019YA11)~~

作者(Author): 龚俊峰;李晓燕;王永杰;

Email:

DOI:

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