Page 119 - 磁共振成像2024年7期电子刊

临床研究｜｜Clinical Articles 磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7

合成MRI联合常规MRI鉴别三阴性

与非三阴性乳腺癌的价值

*
王兰梅，周智鹏 ，徐列印，林斌，余雪燕，王玲廷

作者单位 桂林医学院附属医院放射科，桂林 541001
* 通信作者 周智鹏，E-mail: bigbird_zhou@hotmail.com
中图分类号 R445.2；R737.9 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.019
本文引用格式 王兰梅, 周智鹏, 徐列印, 等 . 合成 MRI联合常规 MRI鉴别三阴性与非三阴性乳腺癌的价值[J]. 磁共振成像, 2024,
15(7): 112-117.
[摘要] 目的 探讨合成 MRI（synthetic magnetic resonance imaging, syMRI）联合常规 MRI 鉴别三阴性乳腺癌（triple negative
breast cancer, TNBC）与非 TNBC 的价值。材料与方法 对经病理证实的 167 例乳腺癌病变进行回顾性分析，TNBC 30 例，非
TNBC 137 例，所有患者均接受 syMRI 检查，测量评估以下参数：纤维腺体组织、实质背景强化、病灶形态、边缘、直径、
T2WI 信号、表观扩散系数（apparent diffusion coefficient, ADC）、强化方式、时间-信号强度曲线、syMRI 参数（T1pre、T2pre、
PDpre、T1Gd、T2Gd、PDGd）。单因素、多因素分析比较 TNBC 组与非 TNBC 组参数，并建立三种预测模型，syMRI模型、常
规 MRI 模型、联合模型（syMRI+常规 MRI），采用受试者操作特征曲线及曲线下面积（area under the curve, AUC）分析各预测
模型鉴别 TNBC与非 TNBC的效能，DeLong检验比较 AUC差异。结果 TNBC组与非 TNBC组间的 T2WI信号、ADC值、边缘
强化、T1pre、T2pre、T1Gd、T2Gd、ΔT2、ΔPD、rT2、ΔT2%、ΔPD%差异具有统计学意义（P<0.05）。多因素 logistic 回归分
析显示，ADC、边缘强化、T2pre、T1Gd、T2Gd 是 TNBC 诊断的独立预测因子（P<0.05），联合模型的诊断性能最高，AUC 为
0.932。结论 基于syMRI、常规MRI建立的预测模型有助于鉴别TNBC和非TNBC。
[关键词] 三阴性乳腺癌；非三阴性乳腺癌；磁共振成像；合成磁共振成像；常规磁共振成像
Value of synthetic MRI and conventional MRI in identifying triple negative and non-triple
negative breast cancer

*
WANG Lanmei, ZHOU Zhipeng , XU Lieyin, LIN Bin, YU Xueyan, WANG Lingting
Department of Radiology, Affiliated Hospital of Guilin Medical College, Guilin 541001, China
* Correspondence to ZHOU Z P, E-mail: bigbird_zhou@hotmail.com
Received 27 Feb 2024, Accepted 25 Jun 2024; DOI 10.12015/issn.1674-8034.2024.07.019
ACKNOWLEDGMENTS Project of Guangxi Natural Science Foundation (No. 2022JJA141266); Technology Application and
Popularization Plan of Guilin in 2022 (No. 20220139-2).
Cite this article as WANG L M, ZHOU Z P, XU L Y, et al. Value of synthetic MRI and conventional MRI in identifying triple negative
and non-triple negative breast cancer[J]. Chin J Magn Reson Imaging, 2024, 15(7): 112-117.
Abstract Objective: To explore the value of synthetic MRI (syMRI) and conventional MRI in identifying triple negative breast cancer
(TNBC) and nonTNBC. Materials and Methods: This retrospective study included 167 patients with pathologically proven breast
cancer. There were 30 cases in the TNBC group and 137 cases in the nonTNBC group. All patients underwent syMRI examinations. The
following parameters were measured and evaluated: fibroglandular tissue, background parenchymal enhancement, lesion shape, edge,
diameter, T2WI signal, apparent diffusion coefficient (ADC), patterns of enhancement, time-signal intensity curve, syMRI parameters
(T1pre, T2pre, PDpre, T1Gd, T2Gd, PDGd). Univariate and multivariate analysis were used to compare the parameters of TNBC group
and nonTNBC group and three predictive models were established: syMRI model, conventional MRI model and Joint model (syMRI+
conventional MRI). Receiver operator characteristic curve and area under the curve (AUC) were used to analyze the efficiency of each
predictive model in distinguishing TNBC and non-TNBC. Then the DeLong test was used to compare the differences in AUC. Results: There
were statistically significant differences (P<0.05) in T2WI, ADC, rim enhancement, T1pre, T2pre, T1Gd, T2Gd, ΔT2, ΔPD, rT2, ΔT2% and
ΔPD% between TNBC group and non TNBC group. Multivariate analyses showed that ADC, the presence of rim enhancement, T2pre,
T1Gd and T2Gd were independent predictors for diagnosis of TNBC (P<0.05). Joint model had the highest diagnostic performance with
an AUC of 0.932. Conclusions: The prediction model established based on syMRI and conventional MRI have value in identifying
TNBC and nonTNBC.
Key words triple-negative breast cancer; non-triple-negative breast carcinoma; magnetic resonance imaging; synthetic magnetic
resonance imaging; conventional magnetic resonance imaging

0 引言 受体 2 均不表达。TNBC 具有高度侵袭性，易局部复
在中国，乳腺癌居女性恶性肿瘤发病率之首， 发及远处转移 ，总体预后极差 ，缺乏有效治疗靶
2020 年新发病例达 42 万 。三阴性乳腺癌（triple 点 [2-3] 。因此准确诊断 TNBC 对于后续治疗方案制订
[1]
negative breast cancer, TNBC）是异质性明显的乳腺 具有重要作用。传统上穿刺或外科手术得到病变组
癌亚型，雌激素受体、孕激素受体、人表皮生长因子 织经过一系列处理和检测方能诊断乳腺癌及其分子

收稿日期 2024-02-27 接受日期 2024-06-25
基金项目 广西自然科学基金项目（编号：2022JJA141266）；2022年桂林市技术应用与推广计划项目（编号：20220139-2）

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