Ma Dejing, Lu Feng, Zou Xuexue, Zhang Hu, Li Yangyang, Zhang Lin, Chen Liang, Qin Dongjing, Wang Bin
Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, 250021, China; Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
Respiratory department, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong, 256603, China.
Magn Reson Imaging. 2017 Feb;36:175-179. doi: 10.1016/j.mri.2016.10.005. Epub 2016 Oct 11.
To investigate the value of use of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to distinguish benign from malignant breast lesions.
Retrospective analysis of data pertaining to 117 patients with breast lesions who underwent DCE-MRI and IVIM-DWI examination with 3.0T MRI was conducted. A total of 128 lesions were pathologically confirmed (47 benign and 81 malignant). Between-group differences in DCE-MRI parameters (Morphology, enhancement pattern, maximum slope of increase (MSI) and time-signal curve (TIC) type) and IVIM-DWI parameters (f value, D value and D* value) were assessed. Multivariate logistic regression was performed to identify variables that distinguished benign from malignant breast lesions. The diagnostic performance of DCE-MRI and DCE-MRI plus IVIM-DWI, to distinguish benign from malignant breast lesions, was evaluated using pathology results as the gold standard.
Lesion morphology, MSI, and TIC type (P<0.05), but not the enhancement pattern (P>0.05), were significantly different between the benign and malignant groups. The f (8.53±2.14) and D* (7.64±2.07) values in the malignant group were significantly higher than those in the benign group (7.68±1.97 and 6.83±2.13, respectively), while the D value (0.99±0.22) was significantly lower than that (1.34±0.17) in the benign group (P<0.05 for all). On logistic regression analysis, the sensitivity, specificity and accuracy of DCE-MRI were 90.1%, 70.2% and 82.8% respectively; the corresponding figures for the combination of IVIM-DWI and DCE-MRI were 88.8%, 85.1%, and 87.5%respectively.
IVIM-DWI method as an adjunct to DCE-MRI can improve the specificity and accuracy in differential diagnosis of benign and malignant lesions of breast.
探讨体素内不相干运动扩散加权成像（IVIM-DWI）作为动态对比增强磁共振成像（DCE-MRI）的辅助手段用于鉴别乳腺良恶性病变的价值。
对117例乳腺病变患者进行回顾性分析，这些患者均接受了3.0T MRI的DCE-MRI和IVIM-DWI检查。共有128个病变经病理证实（47个良性，81个恶性）。评估DCE-MRI参数（形态、强化方式、最大上升斜率（MSI）和时间-信号曲线（TIC）类型）与IVIM-DWI参数（f值、D值和D*值）在组间的差异。进行多因素逻辑回归分析以确定鉴别乳腺良恶性病变的变量。以病理结果为金标准，评估DCE-MRI以及DCE-MRI联合IVIM-DWI鉴别乳腺良恶性病变的诊断性能。
良性和恶性组之间病变形态、MSI和TIC类型有显著差异（P<0.05），但强化方式无显著差异（P>0.05）。恶性组的f值（8.53±2.14）和D*值（7.64±2.07）显著高于良性组（分别为7.68±1.97和6.83±2.13），而D值（0.99±0.22）显著低于良性组（1.34±0.17）（均P<0.05）。逻辑回归分析显示，DCE-MRI的敏感性、特异性和准确性分别为90.1%、70.2%和82.8%；IVIM-DWI与DCE-MRI联合应用的相应数值分别为88.8%、85.1%和87.5%。
IVIM-DWI作为DCE-MRI的辅助手段可提高乳腺良恶性病变鉴别诊断的特异性和准确性。
