摘要
目的通过比较体素内不相干运动扩散加权成像(IVIM-DWI)参数鉴别Ki-67高表达和Ki-67低表达乳腺癌,探讨Ki-67表达与IVIM-DWI参数的相关性。方法对患者的影像学和病理学资料进行回顾性分析,所有患者均行3.0T磁共振IVIM-DWI序列检查。共纳入患者73例共计77个病灶,其中Ki-67高表达病灶54个,Ki-67低表达病灶23个。以病理结果为金标准评估IVIM-DWI参数微血管体积分数(f)、分子扩散系数(D)和灌注相关非相干微循环系数(D~*)在鉴别Ki-67高表达和低表达中的诊断效能。用D值与Ki-67指数的相关性来预测乳腺癌恶性程度。结果乳腺癌Ki-67高表达组D值低于Ki-67低表达组(P<0.05),乳腺癌Ki-67的高表达组D~*值略低于Ki-67低表达组,差异无统计学差异。Ki-67高表达组f值略低于Ki-67低表达组,差异无统计学差异。D值鉴别Ki-67高表达组及低表达组乳腺癌诊断阈值为0.87,其ROC曲线下面积为0.683;D值鉴别Ki-67高表达组及低表达组乳腺癌的敏感度、特异度、准确率分别为91.3%、42.6%、33.9%。乳腺癌的Ki-67增值指数与D值呈显著负相关(r=-0.39,P<0.01)。结论IVIM-DWI参数值有助于预测乳腺癌恶性程度及Ki-67增殖指数表达,其中D值在预测乳腺癌Ki-67表达有一定的价值。
Objective To identify high and low Ki-67-expressing breast carcinomas by comparing the diagnostic value of parameters in intravoxel incoherent motion diffusion-weighted imaging within voxels and to investigate the correlation between Ki-67 expression and parameters in intravoxel incoherent motion diffusion-weighted imaging.Methods Imaging and pathological data of patients were retrospectively analyzed,and all patients underwent IVIM-DWI examination with 3.0 T MRI.Seventy-three patients were included,with 77 lesions,including 54 lesions in the Ki-67 high expression group and 23 lesions in the Ki-67 low expression group.Pathological results were taken as the gold standard to evaluate the role of IVIM-DWI parameters f,D and Dvalues in identifying high and low Ki-67 expression.The correlation between D value and Ki-67 index was used to predict the degree of malignancy of breast carcinoma.Results The D value of the Ki-67 high expression group of breast carcinoma was lower than that of the Ki-67 low expression group(P<0.05).The Dvalue of the Ki-67 high expression group of breast carcinoma was slightly lower than that of the Ki-67 low expression group,and the difference was not statistically significant.The f value in Ki-67 high expression group was slightly lower than that of the Ki-67 low expression group,and the difference was not statistically significant.The diagnostic threshold of D value to identify breast carcinoma in the Ki-67 high expression group and low expression group was 0.87,and D value under the ROC curve was 0.683;the sensitivity,specificity,and accuracy of D value to identify breast carcinoma in Ki-67 high expression group and low expression group were 91.3%,42.6%,and 33.9%,respectively.The Ki-67 staining index of breast carcinoma was significantly negatively correlated with the D value(r=-0.39,P<0.01).Conclusion The IVIM-DWI parameter values help to predict the malignancy of the breast carcinoma and Ki-67 value-added index expression,and the D value has some value in predicting Ki-67 expression in breast carcinoma.
作者
毛锡金
邹雪雪
张骞
李涛
王鹏皓
曹境
李哲
张任翔
田惠颐
MAO Xijin;ZOU Xuexue;ZHANG Qian;LI Tao;WANG Penghao;CAO Jing;LI Zhe;ZHANG Renxiang;TIAN Huiyi(College of Radiology,Binzhou Medical University,Yantai 264003,Shandong,P.R.China;Binzhou Medical University Hospital,Binzhou 256600,Shandong,P.R.China)
出处
《滨州医学院学报》
2022年第4期287-291,共5页
Journal of Binzhou Medical University
基金
国家级大学生创新创业训练计划(202110440074)。
