3-T dynamic contrast-enhanced MRI of the breast: pharmacokinetic parameters versus conventional kinetic curve analysis.
3-T dynamic contrast-enhanced MRI of the breast: pharmacokinetic parameters versus conventional kinetic curve analysis.
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DOI：
10.2214/ajr.10.4665
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Bluemke DA
中科院分区：
文献类型：
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作者：
El Khouli RH;Macura KJ;Kamel IR;Jacobs MA;Bluemke DA
为了评估动态对比度增强（DCE）磁共振成像（MRI）的药代动力学分析的增量值与常规乳腺MRI（形态和动力学曲线类型分析）相比，在表征乳房病变时将其表征为恶性或良性。
该研究得到了我们的机构审查委员会的批准。病变稳定性（5％）。 DCE-MRI结果（I类型I，II或III类型）或药代动力学参数（冲洗率KTRAN，WASHOUT速率KEP和泄漏空间量VE）包括在预测良性诊断与恶性诊断的多变量模型中。
包括101例病变的患者：52％的患者是绝经前，并在期限后48％。良性与恶性肿瘤的诊断（p <0.001）。表现出类似的适度性能改善（AUC，0.88-0.89）。
与高分辨率3D乳房MRI结合使用动力学曲线类型评估或药代动力学建模似乎可提供类似的诊断性能。
To evaluate the incremental value of pharmacokinetic analysis of dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) compared to conventional breast MRI (morphology plus kinetic curve type analysis) in characterizing breast lesions as malignant or benign. The study was approved by our institutional review board. Patients underwent 3D high resolution T1 (3DT1) contrast enhanced MRI and dynamic contrast enhancement (DCE) MRI at 3T, and had pathology proven diagnosis (95%) or more than 2 years follow up confirming lesion stability (5%). Lesions were identified using the high-spatial resolution post-contrast MRI. Morphologic features (margin, enhancement pattern) and conventional DCE-MRI results (kinetic curve types I, II or III) or pharmacokinetic parameters (wash-in rate Ktrans, washout rate Kep, and leakage space volume Ve), were included in multivariate models for prediction of benign versus malignant diagnosis. 95 patients with 101 lesions were included: 52% of patients were pre-menopausal and 48% post-menopausal. Sixty eight lesions (67.3%) were malignant and 33 (32.7%) were benign. There was a significant association between Ktrans and Kep and the diagnosis of benign versus malignant (p<0.001). The AUC for morphologic features (lesion margin and enhancement pattern) was 0.85, while inclusion of Ktrans or Kep in the model showed similar modest improvement in performance (AUC, 0.88–0.89). The use of kinetic curve type assessment or pharmacokinetic modeling in conjunction with high resolution 3D breast MRI appears to offer similar improvement in diagnostic performance..