摘要
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,采用X^(2)检验比较两类病变间形状、边缘、背景实质强化、内部强化特征、早期强化率的差异;采用两独立样本t检验比较DKI、DWI参数的差异,绘制ROC比较其诊断效能。结果DCE-TIC呈平台型的乳腺纤维腺瘤及乳腺癌,形状、边缘、内部强化特征以及早期强化率差异均有统计学意义(P<0.05),背景实质强化差异无统计学意义(P>0.05);MK、MD、ADC值的差异均有统计学意义(P<0.05),联合MK、MD和ADC,ROC下面积为0.991,敏感度、特异度和准确度分别达0.922、1.000和0.922。结论DKI对DCE-TIC呈平台型乳腺纤维腺瘤及乳腺癌具有良好的鉴别诊断意义,将DKI和DWI联合应用可获得更高的诊断效能。
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 X^(2) 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.
作者
李昌帅
梁园园
张亚平
张敏
赵文静
孟凡莲
耿海
LI Changshuai;LIANG Yuanyuan;ZHANG Yaping;ZHANG Min;ZHAO Wenjing;MENG Fanlian;GENG Hai(School of Medical Imaging,Weifang Medical University,Weifang 261053,P.R.China;Department of Radiology,Weifang People's Hospital,Weifang 261041,P.R.China)
出处
《医学影像学杂志》
2021年第3期439-444,共6页
Journal of Medical Imaging
关键词
乳腺肿瘤
磁共振成像
Breast neoplasms
Magnetic resonance imaging
作者简介
李昌帅(1994-),男,山东德州人,潍坊医学院在读硕士研究生,主要从事MRI诊断工作;通信作者:耿海,主任医师,硕士生导师,E-mail:wfrmyyfsk@sina.com。
