More than just being nice: The importance of rapport to understanding

摘要

Objectives: To evaluate diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in the differentiation and characterisation of breast lesions. Methods: Thirty-six women underwent breast magnetic resonance imaging (MRI) including a DWI sequence with multiple b-values (50-3,000 s/mm 2). Mean values for apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) were calculated by lesion type and histological subtype. Differences and correlation between parameters were determined. Results: Forty-four lesions were found. There were significant differences between benign and malignant lesions for all parameters (ADC, p =0.017; MD, p =0.028; MK, p =0.017). ADC and MD were higher for benign (1.96± 0.41×10-3 and 2.17± 0.42×10 -3 mm2/s, respectively) than for malignant lesions (1.33± 0.18×10-3 and 1.52± 0.50×10 -3 mm2/s). MK was higher for malignant (0.61±0.27) than benign lesions (0.37±0.18). We found differences between invasive ductal carcinoma (IDC) and fibroadenoma (FA) for all parameters (ADC,MDandMK): p =0.016, 0.022 and 0.016, respectively. FA and fibrocystic change (FC) showed differences only in MK (p =0.016). Conclusions: Diffusion in breast lesions follows a non-Gaussian distribution. MK enables differentiation and characterisation of breast lesions, providing new insights into microstructural complexity. To confirm these results, further investigation in a broader sample should be performed. Key Points: ? The diffusion kurtosis model provides new information regarding breast lesions ? MD and MK are valid parameters to characterise tissue microstructure ? MK enables improved lesion differentiation ? MK is able to differentiate lesions that display similar ADC values