扩散峰度成像在老年乳腺癌诊断中的应用价值

The value of diffusion kurtosis imaging in diagnosing breast carcinoma in elderly patients

目的探讨扩散峰度成像(DKI)对老年乳腺癌的诊断效能并对比DKI和DWI参数鉴别诊断效能的差异。方法回顾性分析2018年11月~2020年9月就诊于潍坊市人民医院行乳腺MRI检查,后经手术或病理证实的57个良性病灶,42个老年乳腺癌病灶和71个非老年组乳腺癌病灶,观察记录其磁共振影像学表现,测量病灶的扩散加权成像(DWI)参数ADC值以及扩散峰度成像参数平均扩散峰度系数(MK)和平均扩散系数(MD)。以病理结果为金标准,分别将老年乳腺癌与良性病灶和非老年组乳腺癌进行对比分析,采用χ^(2)检验比较乳腺的纤维腺体组织量以及强化后病灶的形状、边缘、早期强化率以及延迟期强化类型的差异;采用两独立样本t检验比较MD、MK、ADC的差异,绘制ROC比较其诊断效能。结果老年乳腺癌患者和乳腺良性病变患者的纤维腺体组织量,强化后病灶的形状、边缘、早期强化率以及延迟期强化类型差异均有统计学意义(P<0.05);MK、MD、ADC值的差异均有统计学意义(P<0.05)。老年乳腺癌和非老年组乳腺癌的纤维腺体组织量差异有统计学意义(P<0.05),强化后病灶的形状、边缘、早期强化率以及延迟期强化类型差异均无统计学意义(P>0.05),MD、MK值差异有统计学意义(P<0.05),而ADC值差异无统计学意义(P>0.05)。结论 DKI对老年乳腺癌具有良好的诊断效能。

Objective To evaluate the diagnostic value of MRI diffusion kurtosis imaging(DKI) in diagnosing breast carcinoma in elderly patients, and compare the diagnostic value of DKI and DWI parameters for differentiating breast carcinoma in elderly patients.Methods Fifty-seven breast benign masses, forty-two breast carcinomas in elderly patients and seventy-one breast carcinomas in other age patients were retrospectively enrolled in the study.All of them underwent 3.0 T MR examinations, including diffusion kurtosis imaging, from November 2018 to September 2020 in Weifang People’s Hospital.All of the lesions’ pathology results were eventually confirmed by surgery or biopsy.The mean kurtosis(MK),mean diffusivity(MD) values and the ADC value were calculated by GE Healthcare AW4.6 workstation.The different of fibroglandular tissue volume, shape, margin, early enhancement rate and delayed enhancement type in benign masses and breast carcinomas in elderly patients, breast carcinomas in elderly patients and other age patients were analyzed with 2 test respectively.Two independent samples t test were used to analyze the differences of MD,MK and ADC values in benign masses and breast carcinomas in elderly patients, as well as breast carcinomas in elderly and other age patients.ROC analysis was used to evaluate the value of ADC,MD and MK in differential diagnosis of benign masses and breast carcinomas in elderly patients, breast carcinomas in elderly and other age patients respectively.Results The fibroglandular tissue volume, shape, margin, early enhancement rate and delayed enhancement type between breast benign masses and breast carcinomas in elderly patients had statistical significance(P<0.05,respectively),but there were no statistical significance(P>0.05,respectively) between breast carcinomas in elderly and other age patients except fibroglandular tissue volume.MK,MD and ADC values had statistical significance(P<0.05,respectively) between breast benign masses and breast carcinomas in elderly patients.MK,MD values had statistical significance(P<0.05,respectively) between breast carcinomas in elderly and other age patients and there was no statistically difference(P>0.05) in ADC value.Conclusion DKI has satisfactory performance in identify breast carcinoma in elderly patients.