分数阶微积分模型DWI结合SMS技术在乳腺良恶性病变中的应用价值

Differentiation of benign and malignant breast lesions using DWI with a fractional-order calculus model based on SMS technique

目的 探讨分数阶微积分(fractional-order calculus, FROC)模型扩散加权成像(diffusion weighted imaging, DWI)结合多层同时(simultaneous multi-slice, SMS)技术在乳腺良恶性病变中的应用价值。材料与方法 回顾性分析2021年1月至2022年12月在我院接受乳腺MRI扫描的124例患者(141个病变),所有患者均应用3.0 T MR行两组多b值(14个b值、最高b值3 000 s/mm^(2)) DWI扫描,一组为常规单次激发平面回波成像(single-shot echo planar imaging, SSEPI)-DWI,另一组为SMS-SSEPI-DWI。采用独立样本t检验或Mann-Whitney U检验比较良恶性病变组的图像质量评分、FROC模型参数值[异常扩散系数(D)、体素内扩散异质性参数(β)和空间参数(μ)]和表观扩散系数(apparent diffusion coefficient, ADC)值。并利用受试者工作特性(receiver operating characteristic, ROC)曲线评价各参数的诊断效能。应用Bland-Altman图评估两组DWI衍生参数间的一致性。结果 乳腺恶性病变的ADC、D、β值均低于良性组,差异具有统计学意义(P<0.05),恶性病变的μ值高于良性组,差异具有统计学意义(P<0.05)。在SSEPI-DWI和SMS-SSEPI-DWI序列中,D值曲线下面积最大,β值诊断敏感性最高,D值特异性最高。Bland-Altman图显示两组DWI序列衍生的相对应参数值均无偏倚,具有良好的一致性。结论 基于SMS-SSEPI-DWI FROC模型可以在临床可接受时间内提供良好的图像质量和病变特征参数值,与SSEPI-DWI相比,其在鉴别乳腺良恶性病变方面具有一致的诊断性能,D值和β值表现出较好的诊断性能。

Objective:To investigate the application value of fractional-order calculus(FROC)model diffusion weighted imaging(DWI)combined with simultaneous multi-slice(SMS)acquisition technology in the differentiation between benign and malignant breast lesions.Materials and Methods:A total of 124 patients(with 141 lesions)who underwent breast MRI scan at our hospital from January 2021 to December 2022 were retrospectively analyzed.All patients underwent DWI scanning with two sets of multiple b values(14 b values,the highest b value was 3000 s/mm^(2))using a 3.0 T MRI system.One group underwent conventional single-shot echo planar imaging(SSEPI-DWI),while the other group underwent SMS-SSEPI-DWI.Independent sample t test or Mann-Whitney U test was used to compare the image quality scores,FROC model parameters(D,β,μ)and apparent diffusion coefficient(ADC)value between benign and malignant groups.The receiver operating characteristic curve was used to evaluate the diagnostic efficacy of each parameter.Bland-Altman plots were used to assess the agreement between the two DWI-derived parameters.Results:The ADC,D andβvalues of malignant breast lesions were significantly lower than those of benign breast lesions(P<0.05),while theμvalue of malignant breast lesions was notably higher than that of benign breast lesions(P<0.05).Among the SSEP-DWI and SMS-SSEP-DWI sequences,the D value had the largest area under the curve,theβvalue demonstrated the highest diagnostic sensitivity,and the D value displayed the highest specificity.Bland-Altman plot indicated unbiased and substantial agreement between the corresponding parameter values derived from the two DWI sequences were unbiased and had good agreement.Conclusions:The FROC model based on SMS-SSEPI DWI can provide high-quality images and lesion characteristic parameter values with shorten scan time.Compared with SSEPI-DWI.It has a comparable diagnostic performance in distinguishing between benign and malignant breast lesions.Particularly.The D andβvalue show better diagnostic performance.