AbstractObjective:To evaluate the value of T1 quantitative parameters of Dynamic Contrast Enhanced MRI (DCE-MRI) at high temporal resolution in the diagnosis of breast lesions and analyze their correlations with MVD, VEGF for breast carcinoma. Materials and Methods:Sixty-seven patients with breast lesions were enrolled from Nov. 2014 to Feb. 2015 in one hospital, underwent the DCEMRI sequence using TWIST with 70 phases. All were conifrmed with pathology within one week. Temporal resolution was 4.58 s per phase except for the ifrst phase 17.3 s. And total scanning time was 5 min 33 s. The following quantitative parameters were calculated: volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular volume fraction (Ve). The Ktrans, Kep and Ve among malignant, benign and normal glandular tissues, and all kinds of ductal carcinoma were calculated and compared by one-way ANOVA and LSD method. Additionally, the areas under the ROC curve of Ktrans, Kep and Ve between malignant and benign lesions were compared. The correlations between quantitative DCEMRI parameters and the microvessel density(MVD), vascular endothelial growth factor(VEGF)of malignant lesions were performed using Pearson correlation analysis.Results:The mean Ktrans, Kep and Ve of normal glandular tissue were (0.012±0.003) min-1, (0.439±0.083) min-1, (0.045±0.013). The mean Ktrans, Kep and Ve of benign lesions were (0.049±0.007) min-1, (0.588±0.073) min-1, (0.107±0.022). The mean Ktrans, Kep and Ve of malignant lesions was (0.187±0.045) min-1, (1.205±0.517) min-1, (0.133±0.049). The difference of Kep, Ktrans between malignant and benign lesions was statistically signiifcant (P=0,P=0.041). The difference of Kep, Ktrans between malignant lesions and normal glandular was statistically signiifcant (P=0,P=0.008). The sensitivity of Ktransand Kep were 86.8% and 67.9%. The speciifcity of Kep and Ktrans were 94.7% and 89.5% using the maximum Youden’ index as the cut-off value. The area under the ROC curve of Ktrans and Kep were 0.931 and 0.819 respectively. The mean Ktrans, Kep and Ve of the 30 patients were (0.183±0.031) min-1, (1.192±0.063) min-1, (0.127±0.031). The amount of MVD was (34.96±9.86) and the score of VEGF was (5±1). The quantitative parameters Ktrans, Kep and Ve were positively correlated with MVD and VEGF (P<0.05). Kep and Ktrans showed signiifcantly statistical correlations with anti-VEGF (r=0.759, r=0.771) and anti-CD34 (r=0.613,r=0.607).Conclusion:The differential diagnosis of benign and malignant breast lesions by Ktrans, Kep were applicable. Ktrans, Kep of breast carcinoma were strongly correlated with MVD and VEGF. They could be used as non-invasive biomarkers to evaluate the microcirculation status of breast carcinoma in vivo.%目的：探讨动态增强磁共振成像(dynamic contrast-enhanced MRI，DCE-MRI)定量参数对乳腺良恶性病变鉴别诊断价值及其与微血管密度(microvessel density，MVD)和血管内皮生长因子(vascular endothelial growth factors，VEGF)的相关性。材料与方法收集河北医科大学第四医院2014年11月至2015年2月67例乳腺病变患者行T1-DCE- MRI扫描，总扫描时相70次，第1时相17.3 s，以后单时相扫描时间4.58 s，总时间约5 min 33 s。测量如下参数：容量转移常数(volume transfer constant，Ktrans)、速率常数(rate constant，Kep)、血管外细胞外间隙容积比(extravascular extracellular volume fraction，Ve)。检查后1周内均经手术取得病理，采用单因素方差分析和LSD法两两比较正常组、良性组及恶性组间定量参数的差异，并绘制ROC曲线分析良、恶性组间的差异。用Pearson相关分析，分析恶性组MVD、VEGF表达与定量参数的相关性。结果正常组Ktrans、Kep、Ve值分别为(0.012±0.003) min-1、(0.439±0.083) min-1、(0.045±0.013)；良性组Ktrans、Kep、Ve值分别为(0.049±0.007) min-1、(0.588±0.073) min-1、(0.107±0.022)；恶性组Ktrans、Kep、Ve值分别为(0.187±0.045) min-1、(1.205±0.517) min-1、(0.133±0.049)。Kep、Ktrans在良、恶性组间差异有统计学意义(P=0，P=0.041)；Kep、Ktrans在正常、恶性组间差异有统计学意义(P=0，P=0.008)。以最大约登指数为最佳诊断切入点， Ktrans、Kep的敏感性分别为86.8%、67.9%。Ktrans、Kep特异性分别为89.5%、94.7%，曲线下面积分别为0.931、0.819。30例乳腺癌患者的Ktrans、Kep、Ve值分别为(0.183±0.031) min-1、(1.192±0.063) min-1、(0.127±0.031)，MVD计数为(34.96±9.86)，VEGF积分为(5±1)分，均与Ktrans、Kep、Ve呈正相关(P＜0.05)。Kep、Ktrans与VEGF相关性最强(r=0.759, r=0.771)，与MVD相关性较强(r=0.613, r=0.607)。结论定量参数Ktrans、Kep对乳腺良恶性病变鉴别诊断有临床价值，且有较高的诊断效能。乳腺癌Ktrans、Kep与VEGF、MVD相关性较强，有望成为无创性评价乳腺肿瘤微循环的新方法。
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