摘要
Abstract
AbstractObjective:To evaluate the value of T1 quantitative parameters of Dynamic Contrast Enhanced MRI (DCE-MRI) at high temporal resolution in the diagnosis of breast lesions and analyze their correlations with MVD, VEGF for breast carcinoma. Materials and Methods:Sixty-seven patients with breast lesions were enrolled from Nov. 2014 to Feb. 2015 in one hospital, underwent the DCEMRI sequence using TWIST with 70 phases. All were conifrmed with pathology within one week. Temporal resolution was 4.58 s per phase except for the ifrst phase 17.3 s. And total scanning time was 5 min 33 s. The following quantitative parameters were calculated: volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular volume fraction (Ve). The Ktrans, Kep and Ve among malignant, benign and normal glandular tissues, and all kinds of ductal carcinoma were calculated and compared by one-way ANOVA and LSD method. Additionally, the areas under the ROC curve of Ktrans, Kep and Ve between malignant and benign lesions were compared. The correlations between quantitative DCEMRI parameters and the microvessel density(MVD), vascular endothelial growth factor(VEGF)of malignant lesions were performed using Pearson correlation analysis.Results:The mean Ktrans, Kep and Ve of normal glandular tissue were (0.012±0.003) min-1, (0.439±0.083) min-1, (0.045±0.013). The mean Ktrans, Kep and Ve of benign lesions were (0.049±0.007) min-1, (0.588±0.073) min-1, (0.107±0.022). The mean Ktrans, Kep and Ve of malignant lesions was (0.187±0.045) min-1, (1.205±0.517) min-1, (0.133±0.049). The difference of Kep, Ktrans between malignant and benign lesions was statistically signiifcant (P=0,P=0.041). The difference of Kep, Ktrans between malignant lesions and normal glandular was statistically signiifcant (P=0,P=0.008). The sensitivity of Ktransand Kep were 86.8% and 67.9%. The speciifcity of Kep and Ktrans were 94.7% and 89.5% using the maximum Youden’ index as the cut-off value. The area under the ROC curve of Ktrans and Kep were 0.931 and 0.819 respectively. The mean Ktrans, Kep and Ve of the 30 patients were (0.183±0.031) min-1, (1.192±0.063) min-1, (0.127±0.031). The amount of MVD was (34.96±9.86) and the score of VEGF was (5±1). The quantitative parameters Ktrans, Kep and Ve were positively correlated with MVD and VEGF (P<0.05). Kep and Ktrans showed signiifcantly statistical correlations with anti-VEGF (r=0.759, r=0.771) and anti-CD34 (r=0.613,r=0.607).Conclusion:The differential diagnosis of benign and malignant breast lesions by Ktrans, Kep were applicable. Ktrans, Kep of breast carcinoma were strongly correlated with MVD and VEGF. They could be used as non-invasive biomarkers to evaluate the microcirculation status of breast carcinoma in vivo.关键词
乳腺肿瘤/磁共振成像/动态增强/微血管密度/血管内皮生长因子Key words
Breast neoplasms/Magnetic resonance imaging/Dynamic enhancement/Microvessel density/Vascular endothelial growth factors分类
医药卫生
