体素内不相干运动联合扩散峰度成像对乳腺癌HER-2表达的判断价值

目的 探讨体素内不相干运动成像(IVIM)联合扩散峰度成像(DKI)对乳腺癌HER-2表达状态的诊断价值.方法 选取本院经病理证实的乳腺癌患者201例,HER-2阳性组106例,HER-2阴性组95例,所有病例均行IVIM及DKI检查.分析两组间的临床病例资料和表观扩散系数(ADC)、真实扩散系数(D)、灌注相关扩散系...

Prediction of the expression of HER-2 in breast cancer based on intravoxel incoherent motion and diffusion kurtosis imaging

Objective To investigate predictive value of intravoxel incoherent motion and diffusion kurtosis imaging for the expression of HER-2 in breast cancer.Methods A total of 201 breast cancer patients confirmed by pathology were collected,including 106 cases in the positive HER-2 group and 95 cases in the negative HER-2 group.IVIM and DKI scanning were performed in all patients.The clinicopathological characteristics and apparent diffusion coefficient(ADC),true diffusion coefficient(D),perfusion-related diffusion coefficient(D^*),perfusion fraction(f),mean diffusion rate(MD)and mean kurtosis value(MK)were analyzed.The differences of clinicopathological data were analyzed byχ² test.The t test of two independent samples was used to compare the differences of IVIM and DKI parameters,and the ROC was plotted to compare the diagnostic efficiency.Results The morphology of breast cancer in the HER-2 positive group was mostly irregular and lymph node metastasis was also common,and there was statistical difference between the two groups(P<0.05).The values of D and MK in the HER-2 positive group were lower than those in the negative group,while the values of D^*and f were higher than those in the negative group,with statistical significance(P<0.05).D and MK were negatively correlated with HER-2.D^*and f were positively correlated with HER-2(|r|=0.149~0.362).When D≤0.69×10^-3 mm²/s,D^*≥26.0×10^-3 mm²/s,f≥32.6,and MK≤0.61,the diagnostic efficiency of positive HER-2 was the highest,among which the AUC of D^*was the largest(0.710),and the specificity and accuracy were the highest with 63.2%and 62.7%,respectively.The AUC of D+D^*+f+MK was 0.815,and the diagnostic efficiency was higher than that of the single index(Z=1.918-4.917;P<0.01),the sensitivity,specificity and accuracy were 78.9%,69.8%and 72.6%,respectively.Conclusion IVIM combined with DKI can be used to predict the expression of HER-2,which is beneficial to individualized treatment of patients.