摘要
目的:探讨扩散峰度成像(Diffusion kurtosis imaging,DKI)联合动态增强磁共振成像(DCE-MRI)对时间信号强度曲线(TIC)Ⅱ型乳腺良恶性病变的诊断价值。方法:回顾性分析本院经病理证实的乳腺肿块患者102例,TIC曲线均为Ⅱ型,其中良性组29例,恶性组73例。分析两组间扩散加权成像(DWI)模型的表观扩散系数(ADC)值,DKI模型的平均扩散率(MD)、扩散峰度(MK)值及DCE-MRI模型的转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)、速率常数(Kep)值;绘制受试者工作特征(ROC)曲线比较其诊断效能。结果:TICⅡ型良性组ADC、MD值大于恶性组,而MK、Ktrans、Kep值小于恶性组,差异有统计学意义(P<0.05),其中MK对TICⅡ型乳腺良恶性病变鉴别的曲线下面积(AUC)为0.879,诊断效能高于其他参数(Z=1.975~2.997,P<0.05)。将MD、MK、Ktrans及Kep纳入Logistic回归分析中,其中MK及Ktrans为鉴别TICⅡ型乳腺良恶性病变的独立影响因素,将MK及Ktrans联合后,AUC为0.922,均高于DWI(AUC=0.696)、DKI(AUC=0.877)、DCE-MRI(AUC=0.877)模型,差异有统计学意义(Z=1.981~3.566,P=0.004)。结论:DKI及DCE-MRI模型均可对TICⅡ型乳腺良恶性病变进行鉴别,DKI模型的MK值联合DCE-MRI模型的Ktrans值的鉴别诊断价值最高,有利于患者术前精准治疗。
Objective:To explore the diagnostic value of diffusion kurtosis imaging(DKI)combined with dynamic contrastenhanced magnetic resonance imaging(DCE-MRI)for TIC typeⅡbenign and malignant breast lesions.Methods:A total of102 patients with breast lesion confirmed by pathology were collected,including 29 cases in the benign group and 73 cases in the malignant group.The TIC curve showed typeⅡ.The ADC values of the DWI model,the MD and MK values of the DKI model,and K~(trans),Ve and Kep values of the DCE-MRI mode were analyzed between the two groups.The ROC curve was drawn to compare the diagnostic efficiency.Results:The values of ADC and MD in TIC typeⅡbenign group were higher than those in malignant group,while the values of MK,K~(trans),Kep were lower than those in malignant group(P0.05).The AUC of MK for discriminating benign and malignant TIC typeⅡbreast lesions was 0.879,and the diagnostic efficiency was higher than the other parameters(Z=1.975~2.997,P0.05).MD,MK,K~(trans)and Kep values were included in the Logistic regression analysis,MK and K~(trans)values were independent influencing factors for discriminating benign and malignant TIC typeⅡbreast lesions.Combining the MK and K~(trans)values,the AUC was 0.922,which was higher than DWI(AUC=0.696),DKI(AUC=0.877)and DCE-MRI(AUC=0.877),and the difference was statistically significant(Z=1.981~3.566,P=0.004).Conclusion:Both DKI and DCE-MRI models can identify the TIC typeⅡbenign and malignant breast lesions.The combination of MK and K~(trans)has the highest differential diagnostic value,which is beneficial for the precise preoperative treatment of patients.
作者
马姝
杨自力
周哲
王唯伟
MA Shu;YANG Zi-li;ZHOU Zhe;WANG Wei-wei(Affiliated Hospital of Jining Medical University,Jining Shandong 272029,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2023年第9期642-646,共5页
Journal of China Clinic Medical Imaging
基金
济宁医学院附属医医学英才培养计划项目(2022-yxyc-010)
济宁医学院附属医院“苗圃”科研计划立项项目(MP-MS-2021-008)。
关键词
乳腺肿瘤
磁共振成像
Breast Neoplasms
Magnetic Resonance Imaging
作者简介
马姝(1983-),女,山东济宁人,主治医师。E-mail:15666928600@163.com;通信作者:王唯伟,济宁医学院附属医院医学影像科,272029。E-mail:1027070940@qq.com。
