Study On The Application Of Multi-b Diffusion Weighted Imaging Of Non-massive Breast Cancer With 3.0T Nuclear Magnetic Vision

Objective:To investigate the value of rFOV DWI in the diagnosis of breast cancer without tumor mass type by comparing small field diffusion weighted imaging?rFOV DWI?with conventional single echo planar diffusion weighted imaging?SS-EPI DWI?.Method:The selection of patients with non palpable breast cancer in 26 cases?age57.2±12.1?,including 18 cases of infiltrating ductal carcinoma?69.2%?,3 cases of ductal carcinoma in situ?11.5%?,2 cases of mucinous carcinoma?7.6%?,3 cases of mixed type carcinoma?11.5%?,and 15 healthy adult volunteers?age 48.8±11.1?,compare in view of small diffusion weighted imaging?rFOV DWI?and the conventional single shot echo planar diffusion weighted imaging?SS-EPI DWI?.The results include:?1?scanning the rFOV DWI and SS-EPI DWI?b values of 0and 800?for the normal nuclear magnetic resonance of breast cancer cases and healthy subjects,comparing the DWI image quality scores and ADC values of rFOV DWI and SS-EPI DWI.To explore the value of ADC values in the diagnosis of no breast cancer in two DWI methods.?2?Check the rFOV DWI and SS-EPI DWI scans at 8 b values?b values set to 0,200,400,600,800,1000,1500,and 2000 s/mm²?and obtain their quantitative parameters.The rFOV DWI and SS-EPI DWI images are postprocessed using the GE Advantage Windows workstation Functool 4.6 software to obtain the parameter values of the single exponential model ADCtotal.The parameters of the IVIM model are calculated using the MADC software,which includes slow spectroscopy,ADC fast,and f?f?values.The quantitative value of rFOV IVIM-DWI group and SS-EPI IVIM-DWI group and the ROC curve analysis were used to evaluate the diagnostic value of rFOV DWI in no lump breast cancer.All data were analyzed by SPSS 19.0 statistical software.Results:1.Comparison of r FOV DWI and SS-EPI DWI image quality score1.1The results showed that the anatomical visual acuity,lesion contrast,artifact and overall image quality score of rFOV DWI group were higher than those of SS-EPI DWI images in 26 cases of breast cancer and 15 healthy subjects.The difference was statistically significant?all P<0.001?.Suggesting that the image quality of the rFOV DWI group is superior to that of the SS-EPI DWI group.1.2 Comparison of ADC values between rFOV DWI group and SS-EPI DWI groupUnder the conditions of b value of 800 s/mm²,26 cases of tumor-free breast cancer cases and 15 cases of healthy individuals SS-EPI and rFOV DWI ADC values were compared and analyzed.The results showed that the mean value of SS-EPI DWI ADC in 26 cases of breast cancer was 1.231±0.21×10^-3 mm ²/s,average rFOV DWI ADC was 1.184±0.15×10^-3mm ²/s,rFOV DWI obtained ADC value was lower than that of the SS-EPI DWI method,the difference was statistically significant?t=3.472,P=0.003?;15 cases of normal gland SS-EPI DWI's average ADC was1.958±0.35×10^-3 mm ²/s,average rFOV DWI was 1.866±0.26×10^-3 mm ²/s,no significant difference between the two ADC value.?t=0.845,P=0.106?.1.3 ROC curve analysis of ADC value of rFOV DWI group and SS-EPI DWI groupIn order to compare the diagnostic value of rFOV DWI and SS-EPI ADC values in the absence of breast cancer and normal breast,the diagnostic efficacy of ADC value was evaluated by ROC curve analysis.The results showed that the area under the curve of rFOV and SS-EPI DWI was 0.981?95%CI,0.967-0.997?and 0.877?95%CI,0.833-0.941?respectively,and the difference was statistically significant?t=7.652,P=0.0006?.Therefore,it can be considered that rFOV and SS-EPI DWI have high accuracy in the differential diagnosis of no lump breast cancer and normal breast,and rFOV is more effective than SS-EPI DWI.2.Study on the Value of rFOV IVIM-DWI and SS-EPI IVIM-DWI Quantitative Parameters in the Diagnosis of Breastless Breast Cancer2.1Comparison of quantitative parameters between rFOV IVIM-DWI group and SS-EPI IVIM-DWI group with multiple b values?ADCtotal,ADCslow,ADCfast,and f-values?of the IVIM-DWI group and the SS-EPI IVIM DWI group were measured at0,200,400,600,800,1000,1500,2000 mm²/s).Analysis showed that ADCtotal and f had significant statistical differences?t=8.626,P=0.000?;?t=7.684,P=0.000?between breast cancer group and normal control group in SS-EPI multiple b-value DWI.In the rFOV multi b value DWI sequence,there was significant difference between the two groups?t=7.255,P=0.000?in the F value between the breast cancer group and the normal control group.2.2 ROC curve analysis of quantitative parameters of tumor-free breast cancer group and normal breast group with multiple b values?1?SS-EPI IVIM DWI group ADCtotal and f-value ROC curve analysisBased on the quantitative analysis of SS-EPI IVIM-DWI group under multiple b values,the difference of ADCtotal and f was statistically analyzed by ROC analysis of differential diagnosis of breast cancer group and normal breast group.The results show that the diagnostic sensitivity is 72%,the specificity is 59.56%,the area under the curve is 0.677?95%CI 0.585⁰.765?when the D is 1.58×10^-3mm²/s,and the boundary of the f parameter,when the value is 0.23%,the sensitivity of diagnosis is62.55%and the specificity is 65.86%.The area under the curve is 0.656?95%CI0.532⁰.767?,which indicates that the accuracy of the tumor is low.?2?rFOV IVIM DWI group f value ROC curve analysisAccording to the quantitative analysis of rFOV IVIM DWI group with multiple b values,the f value with statistical difference was analyzed by ROC analysis of differential diagnosis of breast cancer group and normal breast group.The results showed that the sensitivity of the f parameter was 0.31%,the sensitivity was 43.65%,the specificity was 97.54%,the area under the f value curve was 0.728?95%CI0.665⁰.786?,and the diagnostic accuracy was moderate.?3?ROC curve analysis of f values between rFOV IVIM-DWI group and SS-EPI DWI groupBased on the quantitative analysis of rFOV IVIM-DWI group and SS-EPI IVIM DWI group,the ROC analysis of the differential diagnosis of breast cancer group and normal breast group was performed by f value.The results showed that the f area distribution of rFOV IVIM-DWI and SS-EPI DWI were 0.735 and 0.552,and the difference was statistically different?t=8.676,P=0.0003?.Note that the diagnostic efficacy of the value of f is higher in the r FOV IVIM DWI sequence.Conclusion:1.The anatomical structure of breast rFOV DWI imaging showed that the contrast of lesions was better than that of whole field SS-EPI DWI.By analyzing the image ROC curve,rFOV DWI was better for identifying breast cancer without mass.2.The diagnostic efficacy of rFOV IVIM DWI f in non-mass breast cancer and normal breast tissue was higher than that of SS-EPI IVIM DWI.