目的 评估多模态表观扩散 (MAD) 加权磁共振成像 (MRI) 区分恶性和良性乳腺病变的能力，并预测乳腺癌中 Ki-67 的表达水平。这项回顾性研究对 93 名术后患者进行了回顾性研究。病理证实的乳腺癌或良性乳腺病变。 MAD 图像是使用具有 16 b 值的 3.0 T MRI 扫描仪获取的。计算了 MAD 参数，如流量 (fF、DF)、无阻（流体）(fUI)、受阻（fH、DH 和 αH）和受限（fR、DR）。采用Mann-Whitney U检验比较良恶性病变及Ki-67高低表达水平之间参数的差异。通过受试者工作特征曲线下面积（AUC）评估诊断性能。恶性病变的fR显着高于良性病变（P = 0.001），而fUI和DH显着低于良性病变（P = 0.001）。分别为 P = 0.007 和 P < 0.001）。与区分恶性和良性乳腺病变的单个参数相比，MAD 的组合参数（fR、DH 和 fUI）提供了最高的 AUC（0.851）。 73个恶性病灶中，42个（57.5%）Ki-67低表达，31个（42.5%）Ki-67高表达。 Ki-67高状态显示较低的DH、较高的DF和较高的αH(P < 0.05)。 DH、DF 和 αH 的组合参数为评估 Ki-67 表达水平提供了最高的 AUC (0.691)。MAD 加权 MRI 是乳腺病变诊断和术前预测 Ki-67 表达水平的有用方法。© 2024 . 作者。

To assess the capability of multimodal apparent diffusion (MAD) weighted magnetic resonance imaging (MRI) to distinguish between malignant and benign breast lesions, and to predict Ki-67 expression level in breast cancer.This retrospective study was conducted with 93 patients who had postoperative pathology-confirmed breast cancer or benign breast lesions. MAD images were acquired using a 3.0 T MRI scanner with 16 b values. The MAD parameters, as flow (fF, DF), unimpeded (fluid) (fUI), hindered (fH, DH, and αH), and restricted (fR, DR), were calculated. The differences of the parameters were compared by Mann-Whitney U test between the benign/malignant lesions and high/low Ki-67 expression level. The diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC).The fR in the malignant lesions was significantly higher than in the benign lesions (P = 0.001), whereas the fUI and DH were found to be significantly lower (P = 0.007 and P < 0.001, respectively). Compared with individual parameter in differentiating malignant from benign breast lesions, the combination parameters of MAD (fR, DH, and fUI) provided the highest AUC (0.851). Of the 73 malignant lesions, 42 (57.5%) were assessed as Ki-67 low expression and 31 (42.5%) were Ki-67 high expression. The Ki-67 high status showed lower DH, higher DF and higher αH (P < 0.05). The combination parameters of DH, DF, and αH provided the highest AUC (0.691) for evaluating Ki-67 expression level.MAD weighted MRI is a useful method for the breast lesions diagnostics and the preoperative prediction of Ki-67 expression level.© 2024. The Author(s).