DKI联合DCE-MRI在乳腺病变中的初步研究
本文选题:乳腺病变 + 磁共振动态增强 ; 参考:《川北医学院》2017年硕士论文
【摘要】:目的:1.探讨扩散峰度成像(Diffusion Kurtorsis Imaging,DKI)参数平均扩散峰度(Mean kurtorsis,MK)及其衍生参数平均扩散系数(Mean Diffusion,MD)对乳腺良恶性病变的诊断价值。2.探讨动态增强磁共振扫描(Dynamic Contrast-enhanced Magnetic Resonance Imaging,DCE-MRI)联合DKI对乳腺良恶性病变的诊断价值。材料与方法:按纳入标准随机收集2016年6月至2017年1月因乳腺病变在川北医学院附属医院行MRI平扫、DCE-MRI及DKI扫描患者45例,年龄为21~69岁,平均年龄为44.3±5.9岁,均为女性患者,经术后病理证实的共50个病灶,其中良性病灶21个,恶性病灶29个。从前述45例研究对象中随机选取15例健侧正常乳腺纤维腺体组织作为对照组。分别由两位放射科医生采用盲法独立测量对照组、良性病变组、恶性病变组MD值、MK值,对所得结果进行正态分布及方差齐性检验,采用Kruskal-Wallis检验、单因素方差分析比较MK值、MD值在各组间的统计学差异。分别由两位放射科医生采用盲法按DCE-MRI、DCE-MRI结合DKI两种方法对45例乳腺病变进行分类,组内及组间的比较采用?2检验。绘制ROC曲线,比较两参数、两种方法间的诊断效能。结果:(1)MD值、MK值分别在对照组、良性病变组、恶性病变组间差异均具有统计学意义(P0.05)。恶性病变组MK值0.90±0.19(10-3mm2/s)高于良性病变组0.54±0.13(10-3 mm2/s)与对照组0.48±0.13(10-3mm2/s),恶性病变组MD值1.41±0.32(10-3 mm2/s)低于良性病变组1.98±0.38(10-3 mm2/s)与对照组2.25±0.26(10-3 mm2/s)。根据ROC曲线显示,分别以1.61(10-3 mm2/s)/0.73(10-3 mm2/s)作为MD/MK值诊断乳腺良恶性病变的临界值时,其诊断乳腺恶性病变的灵敏度与特异性分别为77.6%/81.0%、80.0%/93.5%,MD值、MK值曲线下的面积(AUC)分别是0.88、0.95。(2)根据DCE-MRI对乳腺良恶性病变进行分类,其诊断乳腺恶性病变的灵敏度、特异性、阳性预测值、阴性预测值、准确性分别为93.1%、71.4%、81.8%、88.2%、84.0%;根据DCE-MRI联合DKI对乳腺良恶性病变进行分类,其诊断乳腺恶性病变的灵敏度、特异性、阳性预测值、阴性预测值、准确性分别为93.1%、85.7%、90.0%、90.0%、90.0%。两种方法AUC分别为0.86、0.92。结论:(1)DKI参数MK值及其衍生参数MD值对于乳腺良恶性病变的判断具有较高的诊断价值,且MK值诊断效能优于MD值。(2)DKI联合DCE-MRI的使用可以进一步提高DCE-MRI对乳腺恶性病变的诊断效能。
[Abstract]:Purpose 1.To investigate the diagnostic value of mean diffusion kurtosis (mean diffusion kurtosis) of diffusion kurtosis imaging (DKI) and its derived parameter mean diffusion coefficient (mean diffusion coefficient) in the diagnosis of benign and malignant breast lesions.To evaluate the diagnostic value of dynamic Contrast-enhanced Magnetic Resonance imaging DCE-MRI combined with DKI in benign and malignant breast lesions.Materials and methods: from June 2016 to January 2017, 45 patients with breast lesions underwent MRI plain scan DCE-MRI and DKI scan in affiliated hospital of North Sichuan Medical College. The age was 21 ~ 69 years, the average age was 44.3 卤5.9 years.There were 50 lesions confirmed by postoperative pathology, including 21 benign lesions and 29 malignant lesions.Fifteen healthy normal breast fibrous glands were randomly selected from the 45 subjects as control group.The MK values of the control group, benign lesion group and malignant lesion group were measured by two radiologists, respectively. The results were tested by normal distribution and homogeneity of variance, and Kruskal-Wallis test was used.Single factor analysis of variance (ANOVA) was used to compare the statistical difference of MK and MD in each group.45 cases of breast lesions were classified by two radiologists according to the methods of DCE-MRIMr and DKI respectively.Draw the ROC curve, compare the diagnostic efficiency between the two parameters and the two methods.Results there were significant differences in MK and MK between control group, benign lesion group and malignant lesion group (P 0.05).According to the ROC curve, when using 1.61g 10-3 mm2/s)/0.73(10-3 mm 2 / s as the critical value of MD/MK for the diagnosis of benign and malignant breast lesions,The AUC of the two methods was 0.86 ~ 0.92, respectively.Conclusion the MK value of DKI and its derived parameter MD are valuable in the diagnosis of benign and malignant breast lesions, and the diagnostic efficacy of MK value is better than that of MD value. DKI combined with DCE-MRI can further improve the diagnostic efficacy of DCE-MRI in the diagnosis of breast malignant lesions.
【学位授予单位】:川北医学院
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R445.2;R655.8;R737.9
【参考文献】
相关期刊论文 前10条
1 阳君;苏丹柯;赵欣;金观桥;黄向阳;康巍;赵阳;王铮;;动态增强磁共振联合扩散加权成像技术对乳腺环形强化病变的诊断应用价值研究[J];临床放射学杂志;2016年10期
2 孙冬;郭大静;赵建农;;T_2*-PWI联合DCE-MRI及DWI对乳腺病变的诊断价值[J];放射学实践;2016年06期
3 邹雪雪;秦东京;姜兴岳;张虎;马德晶;王静;石清磊;;DCE-MRI联合IVIM-DWI鉴别诊断乳腺良恶性病变[J];中国医学影像技术;2016年04期
4 王高燕;杨光钊;董海波;徐凌斌;王波;李晖;;基于体素内不相干运动DWI在乳腺良恶性病变鉴别中的价值[J];临床放射学杂志;2016年03期
5 邹雪雪;秦东京;张虎;马德晶;张莉;张迪;;IVIM-DWI参数与乳腺浸润性导管癌预后因子ER、c-erbB-2的相关性[J];实用医学杂志;2016年02期
6 王科;潘婷;周欣;吴光耀;;基于非高斯分布模型的扩散加权成像在体部疾病中的应用[J];磁共振成像;2016年01期
7 赵丹;罗娅红;刘凡;何翠菊;赵岩;;Vibrant技术在磁共振双侧乳腺动态增强检查中的应用及优势[J];现代生物医学进展;2015年28期
8 王庆军;王代兵;张静;黄敏华;郭勇;王子军;;年龄、月经状态对乳腺磁共振体素内不相干运动成像的影响[J];中华临床医师杂志(电子版);2015年17期
9 Yuan Wang;Xiaopeng Zhang;Kun Cao;Yanling Li;Xiaoting Li;Liping Qi;Lei Tang;Zhilong Wang;Shunyu Gao;;Diffusion-tensor imaging as an adjunct to dynamic contrastenhanced MRI for improved accuracy of differential diagnosis between breast ductal carcinoma in situ and invasive breast carcinoma[J];Chinese Journal of Cancer Research;2015年02期
10 程流泉;李席如;刘梅;杨娜;张晓晶;张爱莲;;多参数MRI的BI-RADS分类对乳腺病变的诊断效能[J];中国医学影像学杂志;2015年03期
相关博士学位论文 前1条
1 刘春玲;体素内不相干运动成像在乳腺病变中的应用研究[D];南方医科大学;2014年
相关硕士学位论文 前2条
1 于学娟;3.0T-MRI表观扩散系数与乳腺癌病理及分子生物学指标的相关性研究[D];济南大学;2014年
2 程洁;3.0T MRI动态增强扫描、表观扩散系数及磁共振波谱成像在乳腺病变中的诊断价值[D];山西医科大学;2011年
,本文编号:1739909
本文链接:https://www.wllwen.com/yixuelunwen/zlx/1739909.html