RESUMO
Objective@#To investigate the diagnostic value of diffusion kurtosis imaging (DKI) and its combination with DWI for differentiating benign and malignant breast lesions.@*Methods@#Eighty two patients with clinically suspected breast lesions from May 2016 to February 2017 in the Cancer Hospital of Chinese Academy of Medical Sciences were prospectively enrolled in the study. Mammary MRI was performed in all the all patients (89 lesions), and the pathology results were confirmed by surgery or biopsies. All of them underwent 3.0 T MR examinations, including conventional fat-suppression imaging, DWI, DKI and dynamic contrast-enhanced MR imaging (DCE-MRI). The ADC values, mean diffusivity (MD), and mean diffusion kurtosis (MK) values of lesions were obtained, and the lesion morphology, enhancement patterns, and time-signal intensity curve (TIC) types were observed. Independent-samples t test, Mann-Whitney U test were used for the comparison of DKI and DWI between benign and malignant breast lesions. The characteristics of the lesions, enhancement manners and TIC between benign and malignant lesions were analyzed with χ2 test. ROC was used to evaluate the efficacy of DKI and DWI parameters in the differential diagnosis of benign and malignant breast lesions.@*Results@#There was no statistically difference for major axis, fiber types (P>0.05, respectively). The shape of enhancement mode and TIC had statistical significance (P<0.05, respectively). The ADC and MD values were significantly lower in malignant than in benign lesions. Conversely, MK value was significantly higher in malignant lesions than in benign ones, there was a statistically significant difference between these parameters (P<0.05, respectively). Among ADC, MD and MK values, the area under the curve (AUC) of MD for differentiating the benign lesions from the malignancy had the highest diagnosis efficiency (0.975), which was higher than the AUC of MK (0.969) and ADC (0.873). Combing the parameters of DWI and DKI, the diagnostic performance was superior to the single parameter. The AUC of the combination of MD and MK was 0.977, and the parameters of DKI combined with ADC-value had a equal diagnosis efficiency for the combination of MD and MK, which the areas under the ROC curve was 0.978.@*Conclusion@#The parameters derived from DKI can be used to distinguish benign breast lesions from malignant, and the combination of DKI and DWI could obtain a better diagnostic performance than single parameter.
