Diagnostic Value Of Multiple DKI Measurements In Benign And Malignant Breast Lesions

Objective: To investigate the diagnostic value of multiple values of magnetic resonance diffusion kurtosis imaging in benign and malignant breast lesions.Methods: MRI images and pathological data of 38 patients with breast lesions confirmed by surgical biopsy were prospectively analyzed.38 patients had 45 lesions,of which 19(15 cases)had malignant lesions: 1 intraductal carcinoma of the breast,18 noninvasive ductal carcinomas;26 benign lesions(23cases): 2 mammary gland lesions,and 2 cases of atypical hyperplasia and 22 cases of fibroadenoma of mammary glands.All patients had bilateral mammary glands undergoing routine MRI scans and DKI sequence scans.The DKI signal attenuation curves,mean kurtosis(MK),axial kurtosis(AK),radial peaks of breast benign and malignant lesions were obtained by Functool post-processing software.Degree(RK)and mean diffusivity(MD),anisotropy fraction(FA),and apparent diffusion coefficient(ADC)were used to fit the MK,MD,AK,and RK joint diagnostic indices by multiple linear regression analysis.Chi-square test was used to compare the statistical significance of DKI signal attenuation curve type in breast benign and malignant lesions.Mann-Whitney U rank sum test was used to compare the statistical differences of MK,MD,FA,AK,RK,ADC and MK+MD+AK+RK diagnostic index in breast benign and malignant lesions.The use of ROC curves to evaluate the diagnostic value of the above parameter values for benign and malignant breast lesions.Results: The MK,AK,RK and MK+MD+AK+RK combined diagnostic index of breast malignant lesions were significantly higher than benign lesions.The MD and ADC of malignant breast lesions were significantly lower than benign lesions.The differences were statistically significant(P<0.01),there was no significant difference in FA value between groups(P>0.05).The area under the ROC curve(AUC)for the combined diagnostic indices of MK,MD,FA,AK,RK,ADC,and MK+MD+AK+RK was 0.982,0.921,0.601,0.990,0.973,0.923,and 1.000,respectively;The values were 0.662,1.205,0.203,0.715,0.719,1.180,0.483,respectively;the sensitivities were 1.000,0.846,0.579,1.000,1.000,0.962,and1.000,respectively;the specificities were 0.923,0.895,0.846,0.962,0.923,and0.895,1.000,respectively.Conclusion: The MK,MD,AK and RK obtained by DKI have reliable differential value in the diagnosis of benign and malignant breast lesions.The MK+MD+AK+RK combined diagnostic index is more valuable in differential diagnosis of benign and malignant breast lesions.The...