磁共振扩散加权成像联合T2WI图纹理分析定量评估乳腺良恶性结节的价值

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Abstract Objective: To investigate the value of apparent diffusion coefficient (ADC) and T2-weighted imaging (T2WI) texture parameters in quantitative evaluation of benign and malignant breast nodules. Methods: The retrospective study was based on breast ADC and T2WI images. A total of 82 patients with histopathologically confirmed malignant or benign breast nodules from Lishui Municipal Central Hospital were enrolled in this study. Texture features from region of interest (ROI) of breast nodules were extracted from ADC map and T2WI images. Several first-order and second-order texture parameters were generated automatically by post-processing software. The difference of texture parameters between the two groups were compared by Student’s t-test or Mann-Whitney U test. The receiver operating characteristic curves (ROCs) were generated based on the significant variables identified from the univariate analysis, and the area under the curve (AUC), sensitivity, and specificity for nodules differentiation were reported. Z test was used for multiple comparisons of the AUCs with statistical differences between malignant and benign nodules groups. Results: ADCmean, ADCmedian and ADCmin values in breast benign nodule group were significantly higher than those in malignant nodule group (all P<0.05). The skewness and entropy of breast malignant nodule group were significantly higher than benign nodule group (all P<0.05). ROC showed that the thresholds of ADCmean, ADCmedian, ADCmin, skewness and entropy were 1.34×10-3 mm2/s, 1.41×10-3 mm2/s, 0.97×10-3 mm2/s, -0.075 and 3.762, respectively; and AUCs were 0.90 (95%CI= 0.82-0.95), 0.89 (95%CI=0.80-0.95), 0.91(95%CI=0.83-0.96), 0.74 (95%CI=0.64-0.83), 0.95 (95%CI=0.87-0.98), respectively. Comparison of ROCs showed that entropy had the best diagnostic efficiency, and the sensitivity and specificity were 80.55%, 94.74%. AUCs of entropy from ADC, T2WI and both combination showed that the ADC combined with T2WI had the largest entropy AUC (AUC=0.97). Conclusion: Texture parameters based on ADC combined with T2WI images can provide useful proof for differentiating benign breast nodules from malignant, especially for the second-order texture parameters entropy which is expected to provide more diagnostic value for tumor imaging in clinical practice.

Key words： diffusion weighted imaging apparent diffusion coefficient T2-weighted imaging texture analysis breast nodule

Received: 06 December 2018

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	ZHOU Yongjin
	ZHONG Yi
	ZHAO Xuemiao
	GAO Ruijie
	HU Yumin
	YANG Weibin

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2019/V49/I9/667

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