基于术前多参数MRI特征与定量参数构建的预测模型对乳腺癌前哨淋巴结转移的预测价值OA

Objective:To investigate the predictive value of a model constructed based on preoperative multi-parameter MRI features and quantitative parameters for sentinel lymph node(SLN)metastasis in breast cancer.Methods:128 cases of breast cancer diagnosed pathologically were retrospectively analyzed.All patients underwent multi-parameter MRI before surgery,including T1WI,T2WI,DWI and dynamic contrast enhanced MRI(DCE-MRI).The patients were divided into the metastasis group(68 cases)and the non-metastasis group(60 cases)according to pathological results.The preoperative multiparametric MRI features and quantitative parameters(Ktrans,Kep,Ve,and ADC value)between two groups were compared.Tthe indicators with significant statistical differences were further screened by multivariable logistic regression analysis,and a predictive model was constructed.ROC curve was used to analyze the prediction efficiency of the model,calibration curve was drawn to evaluate the calibration degree of the model,and decision curve analysis(DCA)was used to evaluate the clinical application value of the prediction model.Results:Significant differences were found in Ktrans,Kep,tumor size,ADC value,peritumoral vascular signs,lymph node adipose hilum,lymph node margin and ALN symmetry between the two groups(all P＜0.05).Multivariable logistic regression analysis showed that the higher Ktrans,peritumoral edema,peritumoral vascular signs and the lower ADC value were independent risk factors for SLN metastasis(OR=2.372,4.282,8.264,0.042,all P＜0.05).The AUC of the prediction model was 0.832,and DCA showed that the model had strong clinical practicability.Conclusions:The prediction model based on preoperative MRI features and quantitative parameters(Ktrans,ADC value)has a high predictive performance in evaluating the SLN status in breast cancer,which is conducive to optimizing the current treatment strategy for breast cancer patients.