| 周卫平,陈宏伟,昝星有,刘学玲,冯银波,郭榆江,方向明.扩散峰度成像模型与传统扩散加权成像单指数模型鉴别乳腺肿块良恶性的对比分析[J].中国医学影像技术,2016,32(12):1881~1885 |
| 扩散峰度成像模型与传统扩散加权成像单指数模型鉴别乳腺肿块良恶性的对比分析 |
| Diffusion kurtosis imaging and mono-exponential models of diffusion weighted imaging in differentiation of benign and malignant breast masses: Contrastive analysis |
| 投稿时间：2016-07-28 修订日期：2016-10-13 |
| DOI：10.13929/j.1003-3289.2016.12.023 |
| 中文关键词: 扩散磁共振成像 扩散峰度成像 乳腺肿瘤 诊断,鉴别 |
| 英文关键词:Diffusion magnetic resonance imaging Diffusion kurtosis imaging Breast neoplasms Diagnosis, differential |
| 基金项目:国家自然科学基金面上项目（81271629）、江苏省六大人才高峰计划（2014-WSW-062）。 |
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| 中文摘要: |
| 目的 对比分析扩散峰度成像（DKI）模型与传统DWI单指数模型对乳腺良恶性肿块的鉴别诊断价值。方法 对78例乳腺肿块患者于术前行MR检查，包括常规平扫、传统DWI、DKI及动态对比增强（DCE）扫描。通过传统DWI单指数模型获得病灶的ADC值，通过DKI模型获得病灶的平均扩散峰度（MK）及平均扩散系数（MD）值。采用独立样本t检验比较乳腺良恶性肿块间ADC、MK、MD值的差异。以ROC曲线评价ADC、MK和MD值对乳腺恶性肿块的诊断效能。并采用χ2检验比较MK、MD、MK联合MD值的曲线下面积（AUC）与ADC值的AUC间的差异。结果 78例共87个病灶，其中良性病灶29个，恶性病灶58个。恶性病灶的ADC和MD值明显低于良性病灶（P均<0.001），MK值明显高于良性病灶（P<0.001）。良性及恶性病灶的MD值均高于其ADC值（P均<0.001）。以ADC值诊断乳腺恶性肿块的敏感度、特异度、准确率分别为86.21%、89.66%、87.36%；MK值的敏感度、特异度、准确率分别为84.48%、96.55%、88.51%；MD值的敏感度、特异度、准确率分别为82.76%、93.10%、89.66%。MK值的AUC及MK联合MD值的AUC均为0.94（P<0.05），且均高于ADC值的AUC（χ2=5.90，P=0.02），而MD与ADC值的AUC差异无统计学意义（χ2=0.15，P=0.70）。结论 相对于传统DWI单指数模型，DKI模型更有利于乳腺肿块良恶性的鉴别。 |
| 英文摘要: |
| Objective To compare the value of diffusion kurtosis imaging (DKI) model and conventional mono-exponential model of DWI in identifying malignant masses from benign masses of breast. Methods A total of 78 patients with breast mass underwent MR examinations before operation, including routine plain scan, traditional DWI, DKI and dynamic contrast enhanced (DCE) scan. The ADC value was obtained by conventional mono-exponential mode. While the mean diffusivity (MD) and mean kurtosis (MK) values were derived from diffusion kurtosis imaging model. The differences of MD、MK and ADC values between benign and malignant lesions were compared using independent samples t-test analysis. ROC curve analysis was performed to assess the diagnostic efficiency of ADC, MK and MD values. The area under the curve (AUC) was obtained by ROC analysis. And the AUCs of MK, MD, MK combined MD were separately compared with the AUC of ADC using χ2 test. Results There were 87 lesion in 78 patients, Included 29 benign lesions and 58 malignant lesions. The ADC and MD values of malignant lesions were significantly lower than those of benign lesions (both P<0.001). The MK value of malignant lesions was significantly higher than that of benign lesions (P<0.001). For both of benign and malignant lesions, the MD values were significantly higher than ADC values (both P<0.001). The sensitivity, specificity and accuracy of ADC value for differentiating benign lesions from malignant lesions were 86.21%, 89.66% and 87.36%, while those of MK and MD values were 84.48%, 96.55%, 88.51% and 82.76%, 93.10%, 89.66%, respectively. The AUCs of both MK value and the combination of MK and MD values were 0.94 (P<0.05), which were higher than the AUC of ADC value (χ2=5.90, P=0.02). No significant difference was found between the AUCs of MD and ADC values (χ2=0.15, P=0.70). Conclusion Compared with traditional mono-exponential model, DKI model is more beneficial in differentiation of benign and malignant breast masses. |
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