摘要
目的探讨体素内不相干运动成像跟动态增强磁共振成像联合运用在乳腺癌中医证型鉴别诊断方面的临床价值。方法选取了162例经过病理确诊的乳腺癌患者,依据中医辨证分成了肝郁痰凝证(83例)、冲任失调证(44例)以及正虚毒炽证(35例)三组,对各组患者的临床资料、常规MRI特征以及IVIM参数和DCE-MRI参数展开分析。结果三组间病灶形态及强化方式差异有统计学意义(P=0.003;P=0.037)。定量参数分析指出,正虚毒炽证组在D、D*、Ktrans以及Kep值上都高于其他两组,其中Ktrans值对该证型的诊断效能最佳,AUC均大于其他定量参数(Z=2.537~2.831,P<0.05)。DCE-MRI模型为Ktrans+Kep,AUC为0.902,大于IVIM模型(D+D*)(AUC=0.820)及常规MRI模型(AUC=0.765)。DCE-MRI与IVIM的联合模型AUC为0.945,诊断效能高于I V I M、D C R-MRI及常规MRI单一模型(Z=1.995~3.153,P<0.05)。结论IVIM与DCE-MRI的联合运用可为乳腺癌中医证型的鉴别诊断提供更为可靠的影像学依据。
Objective Exploring the clinical value of combining intra-voxel incoherent motion imaging with dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of TCM syndrome types of breast cancer.Methods A total of 162 breast cancer patients confirmed by pathological diagnosis were selected.Based on TCM syndrome differentiation,they were divided into three groups:liver depression phlegm coagulation syndrome(83 cases),Chongren dysfunction syndrome(44 cases),right vacuity exuberant toxin syndrome(35 cases).An analysis of the clinical data,conventional MRI features,IVIM parameters,and DCE-MRI parameters of each group of patients was conducted.Results there were statistically significant differences in lesion morphology and enhancement patterns among the three groups(P=0.003;P=0.037).Quantitative parameter analysis showed that the right vacuity exuberant toxin syndrome group had higher values in D,D^(*),K^(trans),and K_(ep) compared to the other two groups.Among these,the K^(trans) value exhibited the best diagnostic efficacy for this syndrome type,with an AUC greater than that of the other quantitative parameters(Z=2.537~2.831,P<0.05).The DCE-MRI model(K^(trans)+K_(ep))has an AUC of 0.902,which is greater than the IVIM model(D+D^(*))(AUC=0.820)and the conventional MRI model(AUC=0.765).The combined model of DCE-MRI and IVIM had an AUC of 0.945,which was higher in diagnostic performance than the single models of IVIM,DCR-MRI,and conventional MRI(Z=1.995~3.153,P<0.05).Conclusion the combined use of IVIM and DCE-MRI can provide more reliable imaging evidence for the differential diagnosis of TCM syndrome types of breast cancer.
作者
党燕
孙圣峰
李新争
王飞云
张堯
王唯伟
DANG Yan;SUN Sheng-feng;LI Xin-zheng;WANG Fei-yun;ZHANG Yao;WANG Wei-wei(Department of Imaging,Affiliated Hospital of Jining Medical University,Jining 272000,Shandong Province,China)
出处
《中国CT和MRI杂志》
2025年第10期105-108,共4页
Chinese Journal of CT and MRI
基金
山东省中医药科技项目(Q-2022132)
济医附院医学英才培养计划项目(2022-yxyc-010)。
关键词
乳腺癌
中医证型
磁共振成像
体素内不相干运动
动态增强磁共振成像
Breast Neoplasms
TCM Syndrome
Magnetic Resonance Imaging
Intravoxel Incoherent Motion
Dynamic Contrast Enhancement Imaging
