目的 探讨体素内不相干运动(intravoxel incoherent motion,IVIM)定量参数鉴别Luminal型与非Luminal型浸润性乳腺癌的价值.方法 收集经病理证实为浸润性乳腺癌患者148例,其中Luminal型乳腺癌86例,非Luminal型乳腺癌62例.测量感兴趣区的IVIM参数值[真扩散系数(slow ADC,D)、假扩散系数(fast ADC,D*)和灌注分数(perfusion fraction,f)],比较两组间各参数的差异,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价各参数及两者联合对Luminal型与非Luminal型乳腺癌的鉴别效能.结果 Luminal型乳腺癌组的D值[(0.71±0.09)×10-3mm2/s vs(0.84±0.10)×10-3mm2/s]和 f值[18.56(16.00,23.94)vs 24.90(21.01,32.98)]均低于非Luminal型组,组间差异具有统计学意义(P均＜0.05),而D*值在两组间差异无统计学意义.ROC结果显示联合D及f值的曲线下面积(area under the curve,AUC)、特异性及敏感度分别为0.866、81.4％、79.0％.结论 体素内不相干运动定量参数D值和f值可帮助鉴别Luminal型与非Luminal型乳腺癌,两者联合诊断效能更佳.
Quantitative Parameters of Incoherent Voxel Movement to Evaluate Luminal Typing of Invasive Breast Cancer
Objective To explore the value of quantitative parameters of intravoxel incoherent motion(IVIM)in differentiating Luminal and non-Luminal invasive breast cancer.Methods A total of 148 patients with invasive breast cancer confirmed by pathology were collected,including 86 cases of Luminal type breast cancer and 62 cases of non-Luminal type breast cancer.Measure IVIM parameter values[slow ADC(D),fast ADC(D*)and perfusion fraction(f)]in the region of interest.The differences of each parameter between the two groups were compared,and receiver operating characteristic(ROC)curves were drawn to evaluate the differential efficacy of each parameter and their combination in Luminal and non-Luminal breast cancer.Results The values of D[(0.71±0.09)×10-3mm2/s vs(0.84±0.10)×10-3mm2/s]and f[18.56(16.00,23.94)vs 24.90(21.01,32.98)]in the Luminal type breast cancer group were both lower than those in the non Luminal type group,with statistically significant differences(all P＜0.05).However,there was no significant difference in D*values between the two groups.The ROC results showed that the area under the curve(AUC),specificity and sensitivity of combined D and f values were 0.866,81.4％and 79.0％,respectively.Condusion The IVIM quantitative parameters,D and f values,can help distinguish Luminal type from non Luminal type breast cancer,with the combination approach providing better diagnostic efficacy.
Breast CancerLuminal SubtypeIntravoxel Incoherent MotionMolecular Subtype
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