Diagnostic Value Of Combined Application Of DKI And Quantitative DCE-MRI In Benign And Malignant Breast Tumors

Objective To discuss the differential diagnosis performance of diffusion kurtosis imaging（DKI）and dynamic contrast enhancement MRI（DCE-MRI）combined in benign and malignant breast tumors,and the relationship between quantitative parameters.Correlation.Methods A total of 52 patients with breast tumors who were diagnosed and treated in our hospital from October 2020 to January 2022 were retrospectively collected,with a total of 52lesions.According to the pathological results,they were divided into benign case group（22）and malignant case group（30）.The 52 cases in the tumor group underwent conventional MRI scan and DKI scan first,followed by DCE-MRI scan.The original data DKI was imported into GE 4.6 Fooctool to measure the mean diffusion kurtosis coefficient（MK）and mean diffusion coefficient（MD）of the lesions,the raw data DCE-MRI was imported into GE 4.7 Gen IQ to measure the data volume transfer coefficient（Ktrans）,reverse reflux rate constant(K_ep),volume fraction of extravascular space（V_e）.Taking pathological results as the gold standard,two independent samples t test or Mann-Whitney U test were used to compare the statistical differences of different quantitative parameters between benign and malignant breast groups,and ROC curves were drawn to describe the cut-off of each parameter in diagnosing breast cancer.value,area under the curve（AUC）,diagnostic sensitivity and specificity;Z test was used to compare the diagnostic efficacy of each parameter and combined parameters;the correlation between DKI and DCE-MRI perfusion parameters was evaluated by Pearson or Spearman analysis.Results The MK values of benign and malignant breast lesions were 0.642（0.364）and 1.120（0.277）,respectively,and the MD values were 1.214±0.363 and 0.798±0.176,respectively.The MK value of malignant tumors was higher than that of benign tumors,and the MD value of malignant tumors was lower than that of benign tumors,and the differences were statistically significant（P<0.001）.The Kt^ransvalues of benign and malignant breast lesions were 0.085（0.166）and 0.569（0.387）,respectively;the K_epvalues were 0.171（0.348）and 0.505（0.368）,respectively.The K^transand K_epvalues of malignant tumors were higher than those of benign tumors,and the difference was statistically significant（P<0.001）;V_evalues were 0.756（0.275）and 0.530（0.654）,respectively,and there was no significant difference between the two groups（P=0.254）;Among the DKI parameters,the AUC of MK is 0.880,the AUC of MD is0.859,and when MK is combined with MD,the AUC is 0.883.Among the DCE-MRI parameters,the AUC of K^transis 0.930,the AUC of K_epis 0.787,and the AUC of K^transcombined with K_epis 0.939;when the K^trans,K_ep,MK and MD values are combined,the AUC is 0.956,and the maximum Youden index is 0.797,The sensitivity was 93%and the specificity was 86.3%;K^transvalue was moderately positively correlated with MK（r=0.612,P<0.001）,and K^transvalue was moderately negatively correlated with MD（r=-0.608,P<0.001）.).There was a moderate positive correlation between K_epvalue and MK（r=0.525,P<0.001）,and a slight negative correlation between K_epvalue and MD（r=-0.382,P=0.005）.There was no correlation between V_evalue and DKI parameters（MK,MD）values（P>0.05）.Conclusion DKI parameters（MK value,MD value）and quantitative DCE-MRI parameters(K^trans,K_ep)have high diagnostic performance in the diagnosis and differential diagnosis of benign and malignant breast tumors;DKI parameters（MK value,MD value）and quantitative DCE-MRI parameters MRI parameters(K^trans,K_ep)have a certain degree of correlation in depicting perfusion;The combination of DKI parameters（MK value,MD value）and quantitative DCE-MRI parameters(K^trans,K_ep)can improve the diagnostic performance to different degrees,but there is no statistical difference except Kep.