The Clinical Study Of Breast Neoplasm With Advanced MRI Techniques

Purpose: To study and evaluate the diagnostic and differential diagnostic clinical value of magnetic resonance imaging (MRI) in the breast neoplasm with advanced imaging technique. Develop and establish the optimal MR imaging technique criteria and guide to clinical use in the breast cancer.Materials and Method: Thirty-seven female patients with fifty-one lesions being suspected the breast tumor underwent the breast MRI with CP breast array coil(Siemens 1.5T Magnetom sonata). All the patients been done fat-suppressed T1-WI and T2-WI, contrast enhanced dynamic 3-D flash sequence with and without data subtractive imaging, enhanced high spatial resolutions 3-D imaging. The partial patients underwent the diffusion weighted imaging (DWI) and single voxel 1H MRS. Counting and Recording all the data such as early enhancement rate, time-signal curve patterns, lesion's morphological features, ADC map and 1H spectroscopy. All the lesions were confirmed by the histopathologic results. According the pathologic results, all the lesion were divided into two groups, benign and malignant. 31 lesions were benign and 20 lesions were malignant.Results: The age of benign group was 40.10±7.825(x±s)years and the age of malignant group was 50.50±11.75(x±s)years, p=0.0004, <0.01. Compare to the general enhancement rate of two groups, malignant group was definitely higher than the benign group. Compare with the early enhancement rate of two groups, benign group was 0.8387±0.42421 (x±s) and malignant group was 1.1920±0.40203(x±s), p = 0.005, <0.01. The relative analysis (Spearman analysis) of the early enhancement rate with the time-signal intensity curving patterns, p=0.012, <0.05. There are 26 type Ⅰ curving patterns, 2 type Ⅱ curving patterns and 2 type Ⅲ curving patterns in the benign group and 12 type Ⅲ curving patterns, 4 type Ⅱ curving patterns, 4 typeI curving patterns in the malignant group. Compare the curving pattern with two groups, type I curving patterns of two group was x2=22.22 (P<0.01), type Ⅱ was x2 = 0.3430 (P>0.05), and type Ⅲ was x2= 8.6097 (P<0.01). Type I and type Ⅲ curving patterns were significantly different. The partial patients were done the DWI and get the ADC map. From the ADC map, the signal intensity much lower in the malignant lesions and also we get the choline peak form 1H spectrum with MRS in the malignant lesions.Conclusion: MRI is the best imaging method to diagnosis and differential diagnosis breast tumor with high specificity, sensitivity and accuracy in the medical imaginology. Comparing with tumor's morphologic features, contrast dynamic enhancement, 1H spectrum and ADC maps, MRI play an important role for early diagnosis of breast carcinoma.