本文關(guān)鍵詞： 乳腺腫瘤 單指數(shù)模型 DKI模型　出處：《臨床放射學(xué)雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的探討擴(kuò)散加權(quán)成像(DWI)單指數(shù)模型及擴(kuò)散峰度成像(DKI)模型各參數(shù)在乳腺良惡性病變鑒別診斷中的價(jià)值。方法回顧性分析經(jīng)病理穿刺或手術(shù)證實(shí)的40例乳腺病變患者,共有46個(gè)病灶,其中良性病灶27個(gè),惡性病灶19個(gè)。40例均行常規(guī)T_1WI、T_2WI、DWI、DKI及動(dòng)態(tài)增強(qiáng)(DCE-MRI)掃描,通過Advantage Windows4.5后處理工作站獲得由DWI掃描所得參數(shù)表觀擴(kuò)散系數(shù)(ADC)及由DKI掃描所得參數(shù)平均擴(kuò)散系數(shù)(MD)、平均擴(kuò)散峰度(MK)值。采用Mann-Whitney U秩和檢驗(yàn)比較各參數(shù)在良性及惡性病變中的統(tǒng)計(jì)學(xué)差異,采用ROC曲線評(píng)價(jià)各參數(shù)的診斷效能,采用Spearman秩相關(guān)分析ADC值與MD值、MK值的相關(guān)性。結(jié)果惡性病變和良性病變的ADC值、MD值、MK值差異均有統(tǒng)計(jì)學(xué)意義。惡性病變ADC值、MD值明顯低于良性病變(P值均0.05),惡性病變MK值明顯高于良性病變(P0.05)。ADC值、MD值及MK值3個(gè)參數(shù)的ROC曲線下面積分別為0.857、0.876、0.896。以最大約登指數(shù)確定各參數(shù)最佳診斷閾值,分別以1.355×10~(-3)mm~2/s、1.215×10~(-3)mm~2/s、0.4925為閾值,判斷乳腺良惡性病變的敏感性分別為85.2%、88.9%、89.5%,特異性分別為75.2%、76.8%、77.8%。ADC值與MD值呈正相關(guān)性,相關(guān)系數(shù)r=0.704,P0.05;與MK值呈負(fù)相關(guān),相關(guān)系數(shù)r=-0.495,P0.05。結(jié)論乳腺DWI單指數(shù)模型及DKI模型能夠?qū)θ橄倭紣盒圆∽冏龀鲈\斷,但DKI模型具有更高的敏感性及特異性,能夠反映組織微環(huán)境的變化。
[Abstract]:Objective to evaluate the value of DWI single index model and DKI model in differential diagnosis of benign and malignant breast lesions. Methods 40 cases of breast lesions proved by pathological puncture or surgery were retrospectively analyzed. There were 46 lesions, including 27 benign lesions and 19 malignant lesions. All the patients underwent routine T1WII-T2WII-DKI and dynamic enhanced DCE-MRI scans. Advantage Windows4.5 postprocessing workstation was used to obtain the values of parameter apparent diffusion coefficient obtained from DWI scan and average diffusion coefficient from DKI scan. Mann-Whitney U rank sum test was used to compare the parameters in benign and evil. Statistical differences in sexual lesions, The ROC curve is used to evaluate the diagnostic efficiency of each parameter. Spearman rank correlation analysis was used to analyze the correlation between ADC value and MD value and MK value. Results there were significant differences in ADC value and MK value between malignant lesions and benign lesions. The ADC value of malignant lesions was significantly lower than that of benign lesions (P < 0.05), and that of malignant lesions was lower than that of benign lesions (P = 0.05). The area under the ROC curve of the MK value of the lesion was significantly higher than that of the benign lesion (P 0.05, ADC value, MD value and MK value), and the area under the ROC curve was 0.896. The best diagnostic threshold of each parameter was determined by the maximum Jordan index. Taking 1.355 脳 10 ~ (-1) ~ (-3) mm ~ (-1) / s ~ (-1) 215 脳 10 ~ (-1) ~ (-3) mm ~ (-1) ~ 0.4925 as the threshold value, the sensitivity of judging benign and malignant breast lesions was 85.2 ~ 88.9% and the specificity was 75.2 ~ 76.8mm ~ (-1) respectively. The correlation coefficient was 0.704 (P _ (0.05)), and the correlation coefficient was negative correlation with MK value, and the correlation coefficient was 0.704 (P ~ (0.05)), and the correlation coefficient was 0.704 (P ~ (0.05)), which was negatively correlated with MK value. Conclusion DWI single index model and DKI model can be used to diagnose benign and malignant breast lesions, but DKI model is more sensitive and specific and can reflect the changes of tissue microenvironment.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院MRI室;
【分類號(hào)】：R445.2;R737.9

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