Differential diagnosis and clinicopathological study of single index IVIM, DWI, and DKI models in benign and malignant breast lesions

Objective: To explore the value of intravoxel incoherent motion (IVIM)-diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in diagnosing benign and malignant (B/M) breast lesions (BLES), and to provide a basis for early clinical diagnosis of breast cancer (BRCA). Methods: From January 2019 to July 2019, 89 BLES patients with 96 niduses in total, were included and examined by magnetic resonance imaging (MRI) and Multi-b DWI before undergoing operation in our hospital. The apparent diffusion coefficient (ADC) was computed by the single exponential model b of 0 and 1000 s/mm(2), and the parameters were computed by using IVIM and DKI. One-way Analysis of Variance (ANOVA) was utilized to compare the differences of parameters in normal breast tissue (NBT) and B/M BLES. Results: 1. There were statistically significant differences in histology, signal enhancement characteristics, tic curve, maximum enhancement slope, and peak time between BRCA and benign BRCA (P < 0.05). 2. The values of F, D, and D* between malignant and benign BRCA were significantly different (P < 0.05). 3. In the IVIM model, with an increase in B value, the NBTs were determined as normal in DKI model; compared to benign BLES and NBTs, the MK value of malignant BLES was higher; meanwhile, compared to NBTs, the D* value of malignant BLES was significantly higher. Conclusion: The quantitative parameters of dynamic contrast-enhanced (DCE)-MRI and IVIM reflect the permeability and perfusion characteristics of tumor blood vessels, as well as the micro movement of water molecules in the tumor, which are more accurate for the evaluation of tumor angiogenesis and internal tissue characteristics. The D value has high diagnostic efficiency and is critical in the differential diagnosis of B/M BLES.