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Clinical Article
Value of multi-parameter diffusion weighted imaging in the differential diagnosis of benign and malignant TIC type Ⅱ breast lesions
WANG Hongjie  WANG Weiwei  LÜ Siqiang  CHU Yao  LIU Shangkuan  ZHU Laimin  CHEN Yueqin  SUN Zhanguo 

Cite this article as: Wang HJ, Wang WW, Lü SQ, et al. Value of multi-parameter diffusion weighted imaging in the differential diagnosis of benign and malignant TIC type Ⅱ breast lesions[J]. Chin J Magn Reson Imaging, 2022, 13(9): 18-24. DOI:10.12015/issn.1674-8034.2022.09.004.


[Abstract] Objective To explore the value of parameters obtained by mono-exponential diffusion-weighted imaging (DWI), intravoxel incoherent motion-DWI (IVIM-DWI) and diffusion kurtosis imaging (DKI) in the differential diagnosis of benign and malignant breast lesions with plateau time-signal-curve (TIC) type-Ⅱ in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).Materials and Methods A total of 103 cases with breast TIC type-Ⅱ lesions in the Affiliated Hospital of Jining Medical University from October 2019 to January 2021 were reviewed retrospectively. The patients were divided into benign group (25 patients, 25 lesions) and malignant group (78 patients, 78 lesions) according to the pathological results,the ADC value, true diffusion coefficient (D value), perfusion-related diffusion coefficient (D* value), perfusion fraction (f value), mean diffusion rate (MD value) and mean kurtosis value (MK value) were measured. Independent samples t-test was used to compare the differences of each parameter between the two groups, and univariate/multivariate logistic regression analyses were further performed. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the diagnostic efficacy of each parameter alone or combination diffusion models (DWI+IVIM, DWI+DKI and DWI+IVIM+DKI) in differentiating benign and malignant breast TIC type-Ⅱ lesions.Results The ADC, D, f, MD, and MK values of the two groups were significantly different (P<0.05), but the D* value of the two groups had no significant difference (P>0.05). Multiple logistic regression analysis showed that the D value and MK value were independent influencing factors in the differential diagnosis of the two groups, with the largest odds ratio for MK value (AUC 0.871, specificity 88.0%, sensitivity 80.8% and accuracy 78.6%). There was no significant difference in AUC among each combined diffusion model (P>0.05), but three-combination diffusion model achieved the greatest diagnostic efficiency (AUC 0.915, sensitivity 92.3%, specificity 84.0% and accuracy 86.4%), and the AUC of which was statistically higher than that of DWI (AUC 0.816, P<0.05).Conclusions DWI combined with IVIM and DKI have a good differential diagnostic value for benign and malignant breast TIC type-Ⅱ lesions.
[Keywords] breast neoplasms;magnetic resonance imaging;diffusion-weighted imaging;intravoxel incoherent motion;diffusion kurtosis imaging

WANG Hongjie1   WANG Weiwei2   LÜ Siqiang1   CHU Yao1   LIU Shangkuan1   ZHU Laimin2   CHEN Yueqin2   SUN Zhanguo2*  

1 Clinical Medical College of Jining Medical University, Jining 272013, China

2 Department of Medical Imaging, Affiliated Hospital of Jining Medical University, Jining 272029, China

*Sun ZG, E-mail: yingxiangszg@163.com

Conflicts of interest   None.

Received  2021-11-08
Accepted  2022-08-30
DOI: 10.12015/issn.1674-8034.2022.09.004
Cite this article as: Wang HJ, Wang WW, Lü SQ, et al. Value of multi-parameter diffusion weighted imaging in the differential diagnosis of benign and malignant TIC type Ⅱ breast lesions[J]. Chin J Magn Reson Imaging, 2022, 13(9): 18-24.DOI:10.12015/issn.1674-8034.2022.09.004

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