Analysis Of The Value Of DCE-MRI Combined With Different B-Value Diffusion Weighted Imaging In The Diagnosis Of Mass Breast Cancer

Objective:1.To analyze the efficacy of DWI with different b-value in qualitative diagnosis of lump-type breast neoplasm.2.Investigating the differential diagnosis value of DCE-MRI combined with DWI in benign and malignant breast lesions.3.To explore the differences of ADC value and semi-quantitative parameters in different molecular types.Materials:1.From January 2019 to December 2020,106 patients were selected,who visited our hospital because of breast mass.All patients had completed or would be completing DCE-MRI and DWI scans with different b values.Finally,108 lump-type lesions were included in the study.That included 45 benign and 63 malignant lesions on the beside of pathology.According to the expression of different prognostic factors including ER,PR and HER-2,the malignant group would be further classified.There were Luminal-A-like 20,Luminal-B-like 13,HER-2-like20 and triple negative type 10.2.With reference to TIC and BI-RADS,the diagnostic efficiency of DCE-MRI in lump-based breast cancer was analyzed by comparing pathological results.3.The ADC values of benign and malignant breast tumors with different b values were measured.Meanwhile,the diagnostic value of different b values was determined by ROC.Furthermore,calculating the threshold.4.Combining DCE-MRI and DWI to diagnose breast tumors.Furthermore,the diagnostic efficacy of combined method and single method were compared.5.Measuring the Ee,TTP,Vwash and ADC value of malignant lesions.Then,exploring the differences and correlations between these MRI parameters and the different expression states of prognostic factors.Finally,the MRI parameters among the different groups would be compared.Results:1.The sensitivity,specificity and accuracy of DCE-MRI in breast cancer diagnosis were(50/63)79.4%,(30/45)66.7%and(80/108)74.1%,respectively.2.With the same b value,ADC value of breast cancer was lower than that of benign breast disease(p<0.01).When b=1500s/mm~2,DWI has the highest diagnostic efficiency for breast cancer,and its sensitivity,specificity and accuracy were(55/63)87.3%,(36/45)80.0%and(91/108)84.3%,respectively.3.When b=1500s/mm~2,the diagnostic result of DWI combined with DCE-MRI were sensitivity 92.1%,specificity88.9%and accuracy 90.7%,respectively.4.ER/PR positive groups had lower Ee and ADC value,but higher TTP than negative one,and the Vwash of ER positive groups were lower than negative groups(p<0.05).The Vwash of PR positive groups were lower than negative groups(p>0.05).The HER-2 positive groups had lower TTP(p<0.05),but higher Ee,Vwash and ADC value(p>0.05).5.The positive expression degree of ER/PR was negatively correlated with Ee and ADC value,and positively correlated with TTP,meanwhile,the positive expression degree of ER has negative correlation with Vwash(p<0.05).However,the expression level of PR was negatively correlated with Vwash(p>0.05).6.The differences of DCE-MRI semi-quantitative parameters and ADC value at b=1500s/mm~2among different molecular types were statistically significant.The triple negative had the highest Ee,Vwash and ADC value,but lowest TTP in all groups.Luminal-A-like group had lowest Ee and Vwash,but highest TTP.These parameters of HER-2-like and Luminal-B-like were in the middle.Conclusion:1.When b=1500s/mm~2,DWI has the highest diagnostic efficiency for mass breast cancer.2.DCE-MRI combined with DWI is more helpful for the qualitative diagnosis of mass breast cancer.3.There are statistical differences in semi-quantitative parameters and ADC value among different molecular types.4.MRI imaging can not only differentiate benign from malignant,but also predict the molecular typing of living tissues,which is expected to become an important basis for clinical treatment.