Preliminary Research Of DKI Combined With DCE-MRI In Breast Lesions

Objective:(1)To study the quantitative parameters MD and MK of kurtorsis diffusion imaging in the diagnostic values of breast lesions.(2)To study the diagnostic values by the way of comparing between DKI and DKI with Dynamic Contrast-Enhanced(DCE)magnetic resonance imaging(MRI)for breast lesions.Materials and Methods: Data from 45 patients(mean age 44.3±5.9years;range,21–69years)with 50 lesions(29 malignant and 21 benign)who were treated between June 2016 and January 2017 in Affiliated Hospital of North SiChuan Medical College.All lesions were confirmed by postoperrative pathology,then chose 15 patients with normal mammary gland fiber gland tissue as control group.By two radiologists independent to measured MD and MK in control group,benign lesions and malignant lesions.To compare the results between the three groups used normal distribution?analysis of variance to test?Kruskal Wallis rank and One-way ANOVA.DCE,DCE with DKI two methods were used to classify breast lesions,the comparison between benign and malignant lesions empoyed chi-square,with pathologic results as the gold standard,drawing ROC curves.Results: The MD and MK in the control group,benign lesions,malignant lesiongs were statistically significant(P <0.05).The MK coefficients were significantly higher in the malignant lesions than in the benign lesions and control group(0.90±0.19 vs 0.54±0.13 and 0.48±0.13,respectively;P <0.05).The MD values in the malignant lesions were significantly lower than those inthe benign lesions and control group(1.41±0.32 vs 1.98±0.38 and 2.25±0.26,respectively;P<0.05).The area under curve(AUC)for MD was0.88,using1.61(10-3 mm2/ s)as MD cutoff value between benign and malignant lesions,the sensitivity was 77.6% and specificity was 81.0%.For MK,the AUC was 0.95,using 0.73(10-3 mm2/ s)as MK cutoff value between benign and malignant lesions,the sensitivity was 80.0% and specificity was 93.5%.Classification of breast lesions according to DCE-MRI,it's sensitivity?sepcificity?positive predictive value?negative predictive value ?accuacy diagnosis of malignant breast lesions were 93.1%,71.4%,81.8%,88.2%,84.0%;Classification of breast lesions according to DCE-MRI combined with DKI,it's sensitivity?sepcificity?positive predictive value?negative predictive value ? accuacy diagnosis of malignant breast lesions were 93.1%,85.7%,90.0%,90.0%,90.0%,the differences between benign and malignant lesions were statistically significant(P<0.001),AUC of the two methods were 0.86 and 0.92,respectively.Conclusion: DKI quantitative parameters for the diagnosis of breast lesions had high diagnostic value,the diagnostic value of MK was higher than MD;in addition,DKI as a complementary sequence,combined with DCE-MRI can increased the efficiency of the diagnostic of breast lesions.