体素内不相干运动扩散加权成像作为动态对比增强磁共振成像的辅助手段，以提高乳腺良恶性病变鉴别诊断的准确性。
Intravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions.
作者信息
Ma Dejing, Lu Feng, Zou Xuexue, Zhang Hu, Li Yangyang, Zhang Lin, Chen Liang, Qin Dongjing, Wang Bin
机构信息
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.
出版信息
Magn Reson Imaging. 2017 Feb;36:175-179. doi: 10.1016/j.mri.2016.10.005. Epub 2016 Oct 11.
PURPOSE
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.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
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.
目的
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。
材料与方法
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。
结果
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%。
结论
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。
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