摘要
目的评价mDIXON-MRA对乳腺癌腋窝淋巴结是否可切除的临床诊断效能。方法采用回顾性病例-对照研究设计,收集2018年12月至2020年1月在重庆大学附属肿瘤医院影像科磁共振中心进行磁共振检查的乳腺癌患者77例,术前行腋窝区域的mDIXON-MRA、T1WI、T2WI、T2WI(f/s)及T1WI-CE成像,并进行图像后处理重建,由两位放射科医师分别对所得图像根据医师阅片标准进行评估,通过判断淋巴结与周围血管的相互关系以评价淋巴结的可切除性,对比分析不同序列的评分差异。以乳腺科医师的术中判断为标准来绘制ROC(receiver operating characteristic)曲线,进而分析不同序列诊断乳腺癌患者肿大淋巴结能否切除的效能。结果 mDIXON-MRA、T1WI、T2WI、T2WI(f/s)、T1WI-CE组评分平均值分别为(2.01±0.97),(2.22±1.05),(2.22±1.07),(2.42±1.06)和(2.53±1.02),5组序列对于乳腺癌腋窝淋巴结的可切除性评估差异具有统计学意义(P<0.05),其中mDIXON-MRA组的曲线下面积(area under curve, AUC)最高为0.854,与多序列联合应用的AUC相当,评估效能最好。结论 mDIXON-MRA在多种磁共振序列中对评价乳腺癌腋窝淋巴结可切除性的临床诊断价值最高,其诊断效能与多序列联合应用相当。
Objective To evaluate the diagnostic efficacy of modified DIXON magnetic resonance angiography(mDIXON-MRA) in the possibility of axillary lymph node dissection for patients with breast cancer. Methods A retrospective case-control trial was conducted on 77 patients with breast cancer who underwent MRI examination in the Affiliated Tumor Hospital of Chongqing University from December 2018 to January 2020. All the patients preoperatively received mDIXON-MRA, T1 weighted imaging(T1 WI), T2 weighted imaging(T2 WI), fat-suppressed T2-weighted imaging(T2 WI-FS), and contrast-enhanced T1 weighted imaging(T1 WI-CE) on the axillary region. After image post-processing and reconstruction, the obtained images were analyzed and scored by 2 radiologists respectively according to the film reviewing criteria. The resectability of lymph nodes was evaluated by judging the relationship between lymph nodes and peripheral blood vessels, and the difference of scoring the images from different sequences was compared and analyzed. Receiver operating characteristic(ROC) curve was plotted based on the intraoperative judgment of the surgeon, and then the effectiveness of different sequences was analyzed in diagnosis of the resectability of enlarged lymph nodes in breast cancer patients. Results Mean score of the images from mDIXON-MRA, T1 WI, T2 WI,T2 WI-FS and T1 WI-CE were 2.01±0.97, 2.22±1.05, 2.22±1.07, 2.42±1.06, and 2.53±1.02, respectively. And significant differences were observed in the diagnostic effectiveness of axillary lymph nodes resectability based on the 5 sequences(P<0.05). The area under the curve(AUC) of mDIXON-MRA sequence took the highest(0.854) among the 5 sequences, which was equivalent to the area after the combination of multiple sequences, showing the best evaluation efficiency. Conclusion mDIXON-MRA presents the highest clinical diagnostic value among various MRI sequences in the evaluation of the resectability of axillary lymph nodes in breast cancer patients, with its diagnostic efficiency similar to that of combined application of multiple sequences.
作者
谭钰川
吕发金
郑伊能
杨露
但汉丽
李伟
TAN Yuchuan;LYU Fajin;ZHENG Yineng;YANG Lu;DAN Hanli;LI Wei(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016;Chongqing Key Laboratory of Tumor Metastasis and Individualized Diagnosis and Treatment,Affiliated Tumor Hospital of Chongqing University,Chongqing,400030,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2021年第6期541-546,共6页
Journal of Third Military Medical University
