The Study Of MRI Performance And DCE-MRI Quantitative Assessment Analysis In Differentiating The Benign Lesion Of Breast And Breast Carcinoma

Purpose : According to the latest MRI BI-RADS(2013)from ACR,analysis differences between benign lesions of breast and breast carcinoma on morphology and dynamic contract enhanced imaging;through measuring quantitative parameters of dynamic contrast-enhanced MRI,analysis the clinical value of quantitative parameters to identify the benign lesion of breast and breast carcinoma,;at the same time,analysis wether the quantitative parameters are between various subtypes of breast carcinoma.Materials and methods:Collected 64 female patients who had made routine physical examination—ultrasonic testing or breast molybdenum target X-Ray testing,during April 2014 to December 2015,they was found breast lesions which can’t identify the quality.Then use dynamic contrast-enhanced MRI before they had surgery or aspiration biopsy.Check out none of them h~ad chemotherapy or radiation therapy.31 cases of patients are benign breast disease,33 cases of patients are breast cancer.The range of age is 28-76 years old.The molecular classification of breast cancer are based on the immunohistochemical results..Using GE 3.0 MRI scanner and special item 8 channel bilateral breast coil,routine scan including axial T2 STIR sequence,bilateral sagittal T2 FSE Fat Sat sequence,and VIBRANT dynamic contrast-enhanced scanning to observe the imaging manifestation of benign breast disease and breast cancer.According to the MRI BI-RADS,analysis the differences between the benign lesion of breast and breast carsinoma on morphology,TIC curve and quantitative parameters.Using ROC curve to determine the value of quantitative parameters in benign breast disease and breast cancer.According to different types of data,select the corresponding statistical methods,including count data by chi-square test or Fisher’s exact probability test,measurement data using independent sample T test,T test and rank correlation test.Result:The part of MRI performance:1.The proportion of the benign lesion of breast and breast carcinoma on the mass lesion and non-mass lesion is not significant,P value is 0.496;Between breast tumor diseases and breast carcinoma,adenosis of mammary glands and breast cancer lesions,the ratio of mass lesions and non-mass lesion shows are different,statistical significant,the proportion benign breast tumor showing mass lesions is higher than breast carcinoma,the proportion of adenosis of mammary glands showing non-mass lesion is higher than breast carcinoma,P values were 0.009 and 0.038;2.The shapes in benign breast disease and breast cancer samples are different,statistically is significant,P value is 0.000,the proportion of the oval lesions in benign disease group is higher,and irregular lesions of the breast cancer group the proportion is higher;3.In benign breast disease group,the edges often clear,accounted for 86.2%(25/29),but 24.0%(6/25)in the breast cancer group,the difference was statistically significant,P value was 0.000;4.Internal enhancement form distribution is different between the two groups,statistically is significant,P value is 0.007,benign breast disease group shows homogenous enhancement,in breast cancer group,Internal enhancement form often shows uneven or peripheral lesions;5.The proportion of BPE in two groups of has no statistical significance(P =1.00).But some cases shows that the side of the breast which has lesion shows a higher degree of BPE.That are more common in breast cancer group,the proportion is about 28.6%(10/35),which is higher than that in benign breast disease group,6.5%(2/31),P value is 0.004.the difference was statistically significant;6.Two groups of cases show the difference of TIC curve distribution(P = 0.000),the ratio of benign breast disease group show more type I curve accounted for 67.6%(25/37)(1/35),III type curve are only showed in breast cancer group accounted for 45.7%(16/35).The part of quantitative parameters:1.Ktrans value in benign breast disease group is range 0.127±0.059(min-1),Kep value range is 0.509±0.478,Ve value range is 0.368 ±0.202(min-1)..Ktrans value range in breast cancer group was0.212±0.091(min-1),Kep value range is 1.539 ±0.860,Ve value is range 0.190 ±0.144(min-1),among the difference was statistically significant,P = 0.000;2.Ktrans and Kep area under the ROC curve were 0.808,0.898,Ve value area under the ROC curve is 0.213,Ktrans and Kep value differences of benign breast disease and breast cancer have diagnostic value,despite the Ve value there is a clear difference in the two groups,but no actual diagnosis efficiency;3.Ues 0.144(min-1)as Ktrans values boundary value of breast cancer pathological changes,diagnostic sensitivity is 0.793,specificity is 0.775;Use 0.469 as Kep value of breast lesions boundary value,diagnostic sensitivity is 0.931,specificity is 0.875,Kep value in the diagnosis of benign and malignant breast lesion are more efficient;4.Among Luminal A group,Luminal B group,basal-like group,Ktrans,Kep,and Ve value has no statistical difference each part of P value is about 0.072,0.780,0.217.Conclusions:1.According to the MRI BI-RADS standard,the performance of benign lesion of breast and breast cancer are different,especially the shape of the mass lesions,edge,internal enhancement、the type of TIC curve and The BPE of breast can identfy benign lesion and bresst carcinoma of breast.2.The quantitative parameters are different between benign breast disease and breast cancer,.Ktrans value and Kep value has obvious difference for diagnosis,Kep value of diagnostic performance is better.Ve value although is different between to group in statistics,but without real diagnosis efficiency;Different molecular classification of breast cancer,Ktrans value,Kep value,Ve value of each group have no statistically significant difference.