The Application Of 3.0T Diffusion-weighted Imaging In Benign And Malignant Breast Lesions

Objective: To evaluate the application value of the apparent diffusion coefficient values in differential diagnosis of benign and malignant breast lesions, and investigate the correlation between histopathologic classification and ADC values of breast infiltrating ductal carcinoma, and analysis the correlation between ADC values and the molecular biological indicator through 3.0T MR Diffusion-weighted imaging.Methods: Forty-two female patients admitted in breast surgery department of our hospital with breast masses by palpation and underwent conventional MR scanning and diffusion-weighted imaging were collected from May 2014 to January 2015. These patients′contralateral normal glands were taken as control group. All breast lesions cases were confirmed through a surgery pathology. The ADC values of the normal breast, benign lesions and malignant ones were measured through the Philips Extended Workspace. The pathological diagnosis was taken as the gold standard to analysis the ADC values among them. The ROC curve of the patients was made for determining optimal critical value of ADC by which the malignant tumors were found accurately. Besides, sensitivity, specificity and accuracy of the diagnosis were also analyzed. The correlation between histopathologic classification and ADC values of breast infiltrating ductal carcinoma, and the correlation between ADC values and the molecular biological index were investigated, respectively.Results: ①The mean ADC values of normal breast was(1.944 ± 0.148)×10-3mm2/s, while the benign and malignant values were(1.478 ± 0.20)×10-3mm2/s and(1.014±0.19)×10-3mm2/s, respectively. There were statistically differences among them(F=234.890; P=0.000). The average ADC values of normal breast > breast benign lesions(P<0.05), while the breast benign lesions>malignant ones(P<0.05); Made ROC curves for the benign lesions and malignant ones, and obtained the result that value of AUC was 0.952, and the best threshold was 1.197×10-3mm2, meanwhile, sensitivity, specificity and accuracy were 90.0%, 81.8% and 85.7%, respectively.②The mean ADC value of Ⅰ, Ⅱ and Ⅲ level of breast infiltrating ductal carcinoma histopathologic were(1.228±0.112)×10-3mm2/s,(1.014±0.124) ×10-3mm2/s and(0.831±0.146)×10-3mm2/s, respectively. There were statistically differences among them(F=11.36, P<0.05). The mean ADC values of breast infiltrating ductal carcinoma histopathologic level Ⅰ > level Ⅱ(P<0.05), while the breast infiltrating ductal carcinoma histopathologic level Ⅱ> level Ⅲ(P<0.05). There was negative correlation between histopathologic classification and ADC values(r=-0.76, P = 0.000).③ The mean ADC values of ER positive and negative were(0.985±0.198) ×10-3mm2/s and(1.085±0.179)×10-3mm2/s, respectively, there were no significant difference between them(P=0.259). The mean ADC values of PR positive and negative were(0.967±0.207)×10-3mm2/s,(1.086±0.166) ×10-3 mm2/s, respectively, there were no significant difference between them(P=0.167). The mean ADC value of Her-2 different presentation states(-,+,++ and +++) were(1.170±0.148)×10-3mm2/s,(0.969±0.206)×10-3mm2/s,(0.931 ±0.210)×10-3mm2/s and(0.978±0.162)×10-3 mm2/s, respectively. There were no differences among them(F=1.923, P=0.164), and there were no correlation between mean ADC value and the presentation states of Her-2(P=0.058). The mean ADC value of Ki-67 different presentation states(-,+,++ and +++) were(1.211±0.112)×10-3mm2/s,(0.916±0.135)×10-3mm2/s,(0.999±0.153)×10-3mm2/s and(0.895±0.272)×10-3 mm2/s, respectively. There were statistically differences among them(F=4.493, P=0.017). The mean ADC value of the group which Ki-67 presentation state(-) was higher than the other three groups(P<0.05), but there were no differences among the other three groups(P>0.05). There were negative correlation between Ki-67 different presentation states and ADC values(r=-0.465, P=0.034).Conclusion:①.Quantitative indicators of ADC values is helpful to differential diagnosis in breast benign and malignant lesions.②.ADC value of breast infiltrating ductal carcinoma has correlation with histopathologic classification, so the ADC value can help to predict its malignant degree in some extent.③.The mean ADC values has correlation with part of the molecular biological indicator, to speculate that ADC values can predict the breast carcinoma′s biological behavior and evaluate its prognosis in some extent.