MRI扩散峰度成像对乳腺病变的价值分析

The Value of MRI Diffusion Kurtosis Imaging in Breast Lesions

目的探讨磁共振(MRI)扩散峰度成像(DKI)对乳腺病变性质的鉴别诊断作用。方法以2017年1月-2021年7月我院确诊的60例乳腺病变患者为研究对象,行MRI常规扫描与DKI序列扫描。比较常规MRI扫描参数[弥散系数(ADC)]与DKI参数[平均峰度(MK)、轴向峰度(AK)、径向峰度(RK)、平均扩散率(MD)、各向异性分数(FA)]在良、恶性乳腺病变及不同病理类型中的数值差异,并分析其诊断效能。结果良性病变MK、AK、RK值低于恶性乳腺病变,MD、ADC值高于恶性乳腺病变(P<0.05);不同病理类型中ADC、MK、MD、AK、RK值比较,差异有统计学意义(P<0.05);ADC、MD值在浸润性导管癌、导管原位癌、黏液腺癌中呈递增,MK、AK、RK值呈递减,差异有统计学意义(P<0.05);以病理检验为金标准,绘制工作特征曲线(ROC)可知,AK、MK、RK、MD参数诊断恶性乳腺病变的AUC大于传统ADC(P<0.05)。结论DKI中AK、MK、RK、MD参数在乳腺病变性质的鉴别中具有可靠的诊断价值,其诊断效能优于常规ADC参数。

Objective To investigate the differential diagnostic effect of magnetic resonance(MRI)diffusion kurtosis imaging(DKI)on the nature of breast lesions.Methods Sixty patients with breast lesions diagnosed in our hospital from January 2017 to July 2021 were selected as the research objects.Routine MRI scanning and DKI sequence scanning were performed.The numerical differences of conventional MRI scanning parameters[apparent diffusion coefficient(ADC)]and DKI parameters[mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),mean diffusivity(MD),anisotropy fraction(FA)]in benign and malignant breast lesions and different pathological types were compared,and the diagnostic efficiency was analyzed.Results MK,AK and RK values of benign lesions were lower than those of malignant breast lesions,and MD and ADC values were higher than those of malignant breast lesions(P<0.05).The differences in ADC,MK,MD,AK and RK values among different pathological types were statistically significant(P<0.05).ADC and MD values increased in invasive ductal carcinoma,ductal carcinoma in situ and mucinous adenocarcinoma,while MK,AK and RK values decreased,with statistically significant difference(P<0.05).Taking pathological examination as the gold standard,the results of ROC curve shown that the AUC of AK,MK,RK and MD parameters in the diagnosis of malignant breast lesions was greater than that of traditional ADC(P<0.05).Conclusion The parameters of AK,MK,RK and MD in DKI have reliable diagnostic value in the identification of breast lesions,and their diagnostic efficacy is better than that of conventional ADC parameters.