DKI对动态增强时间-信号曲线呈平台型乳腺纤维腺瘤及乳腺癌的诊断价值

目的 探讨扩散峰度成像(DKI)对动态增强时间-信号曲线呈平台型的乳腺纤维腺瘤和乳腺癌的鉴别诊断价值.方法 选取DCE-TIC为平台型的20例(20个病灶)乳腺纤维腺瘤患者和61例(64个病灶)乳腺癌患者.测得病变的平均扩散峰度系数(MK)和平均扩散系数(MD)以及ADC值,观察病变形态和强化特征.以病理结果为金标准,...

The value of diffusion kurtosis imaging in diagnosing breast fibroadenoma and breast cancer in DCE-TIC with plateau type

Objective To evaluate the diagnostic performance of MRI diffusion kurtosis imaging(DKI)between breast fibroadenoma and breast cancer in dynamic contrast enhancement-time signal intensity curve(DCE-TIC)with plateau type.Methods Eighty-one patients with clinically suspected breast lesions whose pathology results were eventually confirmed by surgery or biopsies to be breast fibroadenoma or breast cancer in dynamic contrast enhancement-time signal intensity curve with plateau type from November 2018 to June 2020 in Weifang People's Hospital were retrospectively enrolled in the study.All of them underwent 3.0T MR examinations,including conventional sequence examinations,DWI,DKI and dynamic contrast-enhanced MR imaging(DCE-MRI).The mean kurtosis(MK)and mean diffusivity(MD)values were calculated by the DKI model,and the ADC value was calculated by DWI model.Morphologic characteristics and hemodynamic characteristics(shape,margin,background parenchymal enhancement,inner enhancement feature and early enhancement rate)were analyzed with X² test.The differences of DKI,DWI parameters between breast fibroadenoma and breast cancer in DCE-TIC with plateau type were compared using two independent samples t test.ROC analysis was used to evaluate the value of DKI and DWI parameters in differential diagnosis of breast fibroadenoma and breast cancer in DCE-TIC with plateau type for pathological results as the gold standard.Results The shape,margin,inner enhancement feature and early enhancement rate between breast fibroadenoma and breast cancer in dynamic contrast enhancement-time signal intensity curve with plateau type had statistical significance(P<0.05,respectively).There was no statistically difference for background parenchymal enhancement(P>0.05).All the DKI and DWI values had statistical significance(P<0.05,respectively),Combined with the above three parameters(MK,MD and ADC),the area under the ROC was 0.991.The diagnosis sensitivity,specificity and accuracy were 0.922,1.000 and 0.922 respectively.Conclusion The parameters derived from DKI can be used to distinguish breast fibroadenoma and breast cancer in DCE-TIC with plateau type,and the combination of DKI and DWI could obtain a better diagnostic performance.