Objective To investigate the value of magnetic resonance imaging intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)combined with diffusion kurtosis imaging(DKI)in the diagnosis of breast cancer.Methods A retrospective analysis was conducted on the medical records of 182 patients with breast mass lesions.All patients underwent IVIM-DWI and DKI examinations and quantitative parameters were obtained in terms of apparent diffusion coefficient(ADC),pure diffusion coefficient(D),pseudo diffusion coefficient(D*),perfusion fraction(f),mean diffusion rate(MD),and mean diffusion kurtosis(MK).Puncture biopsy or surgery was performed within 2 weeks after the examination to confirm the nature of the lesion and the molecular typing of breast cancer.IVIM-DWI and DKI parameters of breast cancer patients with different le-sion properties and molecular typing were compared.The ROC curve of the subjects was drawn to analyze the diagnostic value of IVIM-DWI combined with DKI in breast cancer.Spearman correlation was used to analyze the relationship between IVIM-DWI and DKI parameters and molecular typing of breast cancer.Results There were 152 cases of breast cancer and 30 cases of be-nign lesions confirmed by pathological examination in 182 patients.Among the 152 patients diagnosed with breast cancer,there were 62 cases of Luminal A,48 cases of Luminal B,26 cases of the HER-2 positive,and 16 cases of the triple negative.The ROC curve was drawn,and the results showed that the area under the curve(AUC)of IVIM-DWI and DKI separately diag-nosed breast cancer was 0.851 and 0.841,respectively,which had certain diagnostic value.When IVIM-DWI and DKI models were combined,the AUC of breast cancer diagnosis was 0.861,which was higher than the IVIM-DWI or DKI diagnosis results alone(P<0.001).The sensitivity of combined diagnosis was 86.7%,and the specificity was 79.6%,which had good diagnostic value.The ADC,D and MD values of triple negative breast cancer patients were the lowest,followed by HER-2 positive type and Luminal B type,and Luminal A type was the highest(P<0.05).The f and MK values of patients with triple negative breast cancer were the highest,followed by HER-2 positive type and Luminal B type,and Luminal A type was the lowest(P<0.05).Spearman correlation test showed that IVIM-DWI parameters ADC,D,f and DKI parameters MD,MK were correlated with mo-lecular typing of breast cancer(P<0.05).Conclusion IVIM-DWI combined with DKI has high diagnostic value for breast cancer,and IVIM-DWI parameters ADC,D,f and DKI parameters MD,MK are closely related to the molecular typing of breast cancer.
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