Clinical Evaluation Of Combining Dynamic Contrast-enhanced MR Imaging,Diffusionweighted MR Imaging For Diagnosis Of Breast Lesion

Objective:To analyze the sensitivity,specificity and positive likelihood rate,negative likelihood rate of dynamic contrast-enhanced imaging,diffusion-weighted imaging and combination of the two methods for the diagnosis of breast lesion,and to evaluate their diagnostic validity.Methods:Thirty-seven lesions from 37 patients were acquired with histopathological demonstration,of which 19 were malignant and 18 were benign.All lesions were examined with dynamic contrast-enhanced MRI and DWI.The images were reviewed by two radiologists at ADW 4.3 workstation and made con-sensus on the shape,contour and the type of time-signal intensity curve(TIC).The lesions were classified as malignant,suspicious or benign according the score summed up.Apparent diffusion coefficient(ADC) of the lesion was acquired using region of interest(ROI) technique correlated with the location of enhanced lesion by Functool software on the workstation. T test statistical method used to compare ADC,and lesions were classified as benign and malignant.The validities of dynamic contrast-enhanced imaging,ADC,and combination of the two methods were evaluated.Results.The sensitivity,specificity and positive likelihood rate,negative likelihood rate of dynamic contrast-enhanced imaging were 89.5%(17/19),72.2%(13/18) and 3.221,0.146. The benign lesion group ADC was 1.474±0.441(×10^-3mm²/s),and the malignant group was 1.082±0.160(×10^-3mm²/s).To the total numbers had significant difference (P=0.002,＜0.05).The sensitivity,specificity and positive likelihood rate,negative likelihood rate of ADC were 94.7%(18/19),66.7%(12/18) and 2.842,0.079.The combination of dynamic contrast-enhanced MRI and DWI-ADC of breast lesions had a sensitivity, specificity and positive likelihood rate,negative likelihood rate of 94.7%(18/19),83.3%(15/18) and 5.684,0.063.Conclusion:1.The spicule sign was more sensitivity and specificity for the diagnosis of breast malignant lesions.2.The time-signal intensity curve of dynamic contrast-enhanced imaging:The wash-in curve was more sensitivity and less specificity for the diagnosis of breast benign lesions;The wash-out curve was more sensitivity for the diagnosis of breast malignant lesions;The plateau curve was more overlap for the diagnosis of breast lesions.3.The ADC was more sensitivity and correctly for the diagnosis of breast lesions.4.The combination of dynamic contrast-enhanced MRI and DWI was more diagnostic validity than only the other diagnosis examination in sensitivity,specificity and positive likelihood rate,negative likelihood rate for the diagnosis of those breast lesions.