The Study On The Diagnostic Value Of 3.0T Magnetic Resonance Multiparameter Independent And Combined In Benign And Malignant Breast Lesions

Objective:To explore the diagnostic value of 3.0T MR T₂-weighted fat suppression（T₂WI-FS）,diffusion-weighted imaging（DWI）,dynamic contrast-enhanced imaging（DCE）multiparametric applications independently and the combination of different combinations of multiparametric applications on benign and malignant breast lesions.The optimal combination of parameters was selected by statistical analysis and comparison,aiming to improve the diagnostic efficacy of benign and malignant breast lesions.Methods:The MRI data of patients who found breast lesions by themselves or Clinical physical examination and underwent conventional MRI plain scan,DWI and DCE examination in Wuzhou Hospital Affiliated to Youjiang Medical College for Nationalities were prospectively included from April 2020 to August 2022.A total of 60 patients with 64lesions（34 benign lesions and 30 malignant lesions）were included.All the results were confirmed by pathology.All data were statistically analyzed using SPSS 25.0 and Medcalc18.0 software.All the measurement data were tested for normality,and the measurement data in accordance with normal distribution were expressed by mean±standard deviation and compared with independent sample t-test,while the measurement data of non-normal distribution were expressed as median（upper and lower quartile）and compared with Mann-Whitney U test.Fisher’s exact test was performed for the comparison of count data.The receiver operator characteristic curve（ROC）was drawn and the AUC of T₂SI,each DWI parameter and TIC curve were obtained.The parameter with the highest diagnostic efficacy among T₂SI and DWI parameters,e ADC,and TIC curve were selected and the ROC curve was jointly plotted to assess the diagnostic efficacy.P<0.05 was considered statistically significant.Results:There were 34 benign and 30 malignant lesions out of a total of 64 lesions in 60cases.There were significant differences in T₂SI,ADC,r ADC,e ADC,re ADC,DWI parameters and TIC curve between benign and malignant breast lesions（P<0.05）.The thresholds were 1276,1.22×10^-3mm²/s,0.81,0.33,1.67,0.47,1.00 respectively.The sensitivity was 76.67%,96.67%,66.67%,80.00%,40.00%,86.67%and 100.00%respectively,and the specificity was 70.59%,67.65%,76.47%,85.29%,91.18%,85.29%and61.76%,respectively.The Jordan index was 47.25%,64.31%,43.14%,65.29%,31.18%,71.96%and 61.76%,respectively.There was no significant difference in AUC between e ADC and DWI multiparametric combination（P>0.05）.The AUCs for the combination of T₂SI+e ADC,T₂SI+TIC,e ADC+TIC,and T₂SI+e ADC+TIC were 0.88,0.93,0.98,and 0.98,respectively,with sensitivities of 80.00%,93.33%,93.33%,and 93.33%,specificities of88.24%,85.29%,94.12%,94.12%,and the Jorden index was 68.24%,78.63%,87.45%,87.45%,respectively.The differences in r T₂SI for benign and malignant breast lesions were not statistically significant（P>0.05）.The inflow curves of TIC were all benign lesions,the outflow curves were malignant lesions,and the plateau curves were overlapping between benign and malignant lesions,and malignant lesions accounted for a higher proportion,accounting for 62.86%.Conclusion:（1）In this study,the independent application of T₂SI,ADC,e ADC and TIC curves and the combination of DWI multi-parameters have high diagnostic efficacy for benign and malignant breast lesions,and e ADC has the highest diagnostic efficiency among the parameters of DWI.（2）The diagnostic accuracy of r ADC and re ADC in the diagnosis of benign and malignant breast lesions in this study is low,and their value in predicting benign and malignant breast lesions is limited.（3）In this study,all TIC inflow-type curves were benign lesions,all outflow-type curves were malignant lesions,and there was more overlap between benign and malignant lesions in the plateau-type curves,among which the proportion of malignant lesions was higher.（4）In this study,the combination of T₂SI,e ADC and TIC can effectively improve the diagnostic efficacy of benign and malignant breast lesions.The AUC and Jorden index of T₂SI+e ADC,T₂SI+TIC,e ADC+TIC and T₂SI+e ADC+TIC combination were higher than each parameter applied independently.The diagnostic efficacy of the combination of e ADC+TIC was the highest,and the combination of e ADC+TIC was the recommended combination.