DKI与DWI在乳腺良恶性病变诊断价值的对照研究  

A comparative study on the diagnostic value of DKI and DWI in benign and malignant breast lesions

作　　者：刘绍伟[1] 祝新[1] 崔文静[1] 陈晓[1] 

机构地区：[1]南京中医药大学附属医院放射科,江苏南京210029

出　　处：《医学影像学杂志》2017年第9期1726-1730,共5页Journal of Medical Imaging

摘　　要：目的评估磁共振弥散峰度成像(DKI)与弥散加权成像(DWI)对乳腺良恶性病变诊断价值及效能差异。方法对31例乳腺占位性病变的女性患者行乳腺常规磁共振扫描(T_1WI,T_2WI)、动态增强扫描及DWI和DKI扫描,所有病变均经手术或穿刺病理证实。总共37个病灶,其中良性病变9个,恶性病变28个。分析病变大小、形态、边界等基本情况以及测定表观弥散系数(ADC)、平均峰度(MK)及平均弥散系数(MD)值。采用ROC曲线评估ADC、MK及MD鉴别良恶性病变的价值及差异。结果恶性病变多表现为形态不规则、边界不清晰;恶性病变多为平台型强化;良性病变的MK低于恶性病变;良性病变的MD、ADC均高于恶性病变,具有显著的统计学意义(P<0.01)。ROC曲线显示MK的曲线下面积(AUC)、敏感度及特异度均为最高,分别为0.91,0.93及0.89。结论 DKI比传统DWI在乳腺良恶性病变方面有更高的诊断效能。Objective To evaluate the diagnostic performances of diffusion kurtosis imaging （ DKI） and diffusion-weighted imaging in differentiation of benign and malignant breast lesions. Methods Thirty-one patients with breast lesions underwent magnetic resonance imaging （ MRI, T1 weighted imaging and T2 weighted imaging） , dynamic enhanced imaging, DWI and DKI. All the patients underwent surgery or biopsy. There were 37 lesions, including nine benign lesions and 28 malignant lesions. Size, shape, boundary, apparent diffusion coefficient （ ADC） , mean diffusivity （ MD） and mean kurtosis （ MK） value were eval-uated. Receive operate curve （ ROC） was used to evaluate the diagnostic performance of ADC, MD and MK in differentiating be-nign and malignant breast lesions. Results Irregular shape and ill-defined boundary were more common in malignant lesions than the benign lesions. Malignant lesions usually showed plateau of enhancement. The MK values of benign lesions were lower than those of malignant lesions;the ADC and MD values of benign lesions were higher than those of malignant lesions ROC analy-sis showed the area under curve （AUC）, the sensitivity, specificity of MK（0. 91,0. 93,0. 89, respectively） were all higher than MD and ADC value. Conclusion This study demonstrated that DKI showed better performance in differentiating benign and ma-lignant breast lesions.

关 键 词：磁共振成像 乳腺疾病 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]