The predictive value of diffusion kurtosis imaging combined with quantitative dynamic contrast-enhanced magnetic resonance imaging for axillary lymph node metastasis of breast cancer
Objective To investigate the value of diffusion kurtosis imaging(DKI)combined with quantitative dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in predicting axillary lymph node metastasis in breast cancer.Methods A total of 150 cases of breast cancer confirmed by pathology in the Affiliated Hospital of Jining Medical University were retrospectively analyzed.68 cases had axillary lymph node(ALN)metastasis and 82 cases had no ALN metastasis.All breast lesions were examined by DKI and DCE-MRI before operation.We analyzed clinical case data,routine MRI features,DKI,and DCE-MRI parameters between two groups,including diffusion kurtosis(MK),mean diffusion rate(MD),volume transfer constant(Ktrans),extravascular volume fraction(Ve),and rate constant(Kep);The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of quantitative parameters for ALN metastasis of breast cancer.Results The proportion of lesions with blurred edges in the metastatic group was higher than that in the non ALN metastatic group(P=0.032);The proportion of uneven and circular enhancement within the ALN metastasis group was relatively high(P=0.018).The MD value of the ALN transfer group was lower than that of the group without ALN transfer(P=0.021);The MK value,Ktrans value,and Kep value were higher than those in the group without ALN metastasis(all P＜0.01).The Ksvalue of DCE-MRI model was the most effective in diagnosing ALN metastasis of breast cancer,and the area under the ROC curve(AUC)was 0.831;The AUC of DCE-MRI model was 0.833,which was higher than that of DKI model(AUC=0.733),and the difference was statistically significant(Z=2.208;P=0.027).The AUC of DCE-MRI and DKI models were higher than that of conventional MRI models(Z=3.184,P=0.002;Z=1.917,P=0.046).The sensitivity and accuracy of combined DKI and DCE-MRI models in the diagnosis of ALN metastasis in breast cancer were higher than those of single model.Conclusions DKI and DCE-MRI models can be used to predict axillary lymph node metastasis in breast cancer.Among them,the Ktrans value of DCE-MRI model is the most effective in diagnosing axillary lymph node metastasis in breast cancer.
Breast neoplasmsLymphatic metastasisDiffusion kurtosis imagingDynamic contrast enhancement imaging
万方数据
维普
