IVIM成像技术诊断乳腺癌中ROI勾画方式对测量结果的影响

Influence of different ROI sketch on measurement results in the diagnosis of breast cancer by imaging technology of IVIM

目的研究体素内不相干运动(intravoxel incoherent motion,IVIM)成像诊断乳腺癌的价值及感兴趣区(region of interest,ROI)勾画方式对测量结果的影响。方法收集2017年4月至2021年10月84例乳腺肿块性病变患者临床资料,患者均行IVIM-DWI检查,采用肿瘤轮廓法和固定半径法在肿块最大层面勾画ROI。记录表观扩散系数(apparent diffusion coefficient,ADC)值、真实扩散系数(true diffusion coefficient,D)、灌注分数(perfusion fraction,f)及假性扩散系数(pseudo-diffusion coefficient,D^(*)),比较良恶性乳腺肿瘤患者各IVIM-DWI参数。比较肿瘤轮廓法和固定半径法勾画ROI对IVIM相关参数结果的影响。结果84例患者中46例为恶性肿瘤,38例为良性肿块。恶性组患者ADC值、D值分别为(0.98±0.24)×10^(-3) mm^(2)/s、(0.79±0.22)×10^(-3) mm^(2)/s,均显著低于良性组的[(1.65±0.43)×10^(-3) mm^(2)/s、(1.41±0.35)×10^(-3) mm^(2)/s];f值、D^(*)值分别为(5.65±1.13)%、(43.89±8.05)×10^(-3) mm^(2)/s,均显著高于良性组的[(3.84±1.57)%、(37.77±9.3)×10^(-3) mm^(2)/s],差异有统计学意义(t=9.01、9.89、6.13、3.23,P均<0.05)。肿瘤固定半径法勾画ROI所得结果显示,恶性组患者ADC值、D值分别为(0.96±0.27)×10^(-3) mm^(2)/s、(0.81±0.23)×10^(-3) mm^(2)/s均显著低于良性组的[(1.66±0.39)×10^(-3) mm^(2)/s、(1.39±0.37)×10^(-3) mm^(2)/s];f值、D^(*)值为(5.69±1.15)%、(43.94±7.98)×10^(-3) mm^(2)/s,均显著高于良性组的[(3.86±1.49)%、(38.01±8.46)×10^(-3) mm^(2)/s],差异有统计学意义(t=9.69、8.78、6.35、3.30,P均<0.05)。采用肿瘤轮廓法勾画ROI所得ADC差值、D值差值、f值差值及D^(*)值差值的95%一致性区间范围较肿瘤固定半径法更小。结论IVIM成像技术诊断乳腺癌准确性高,且肿瘤轮廓法勾画ROI所得IVIM参数重复性好。

ObjectiveTo study the influence of different region of interest(ROI)sketch on measurement results in the diagnosis of breast cancer by imaging technology of intravoxel incoherent motion(IVIM).MethodsThe clinical dataes of 84 patients with breast mass lesions from Apr.2017 to Oct.2021 were collected,all patients underwent IVIM-DWI.ROI was delineated at the maximum level of the mass by tumor contour method and fixed radius method.The apparent diffusion coefficient(ADC),real diffusion coefficient(D),perfusion fraction(f)and pseudo diffusion coefficient(D^(*))were recorded.IVIM-DWI parameters of patients with benign and malignant breast tumors were compared.The influence of ROI delineation by tumor contour method and fixed radius method on the results of IVIM related parameters were compared.ResultsForty-six of 84 patients were malignant and 38 benign masses.The ADC and D values of patients in the malignant group were(0.98±0.24)×10^(-3) mm^(2)/s,(0.79±0.22)×10^(-3) mm^(2)/s in the malignant group,significantly lower than those in the benign group[(1.65±0.43)×10^(-3) mm^(2)/s,(1.41±0.35)×10^(-3) mm^(2)/s],and the f value and D^(*)value were(5.65±1.13)%,(43.89±8.05)×10^(-3) mm^(2)/s,significantly higher than those in the benign group[(3.84±1.57)%,(37.77±9.3)×10^(-3) mm^(2)/s].The differences were statistically significant(t=9.01,9.89,6.13,3.23;all P<0.05).The results obtained by using the tumor fixed radius method to delineate ROI showed that the ADC and D values of(0.96±0.27)×10^(-3) mm^(2)/s(0.81±0.23)×10^(-3) mm^(2)/s in the malignant group were significantly lower than those in the benign group[(1.66±0.39)×10^(-3) mm^(2)/s,(1.39±0.37)×10^(-3) mm^(2)/s],and the f and D^(*)values were(5.69±1.15)%,(43.94±7.98)×10^(-3) mm^(2)/s,which were significantly higher than those in the benign group[(3.86±1.49)%,(38.01±8.46)×10^(-3) mm^(2)/s].The differences were statistically significant(t=9.69,8.78,6.35,3.30;all P<0.05).The 95%consistency interval range of ADC difference,D value difference,f value difference,and D^(*)value difference obtained by using tumor contour method to delineate ROI was smaller than that of tumor fixed radius method.ConclusionsThe IVIM has high accuracy in the diagnosis of breast cancer,the IVIM parameters obtained from ROI delineation by tumor contour method have good repeatability.