The Applicative Value Of MR Diffusion-weighted And Dynamic Contrast-enhanced Imaging In The Diagnosis Of Breast Lesions

Backgrounds and Objective MRI has played a very important role in the diagnosis of breast lesions now,especialy diffusion-weighed and dynamic contrast-enhanced imaging,which have develeped much faster. we carried out this study in order to evaluate the clinical value of both diffusion-weighed and dynamic contrast-enhanced imaging on breast lesions.Materials and Methods1.Collecting 40 women with breast lesions.age 23-66, average age 46, all cases were after surgery or puncture pathology, and selecting 15 healthy women as control group, age 22-62,average age 40.30 cases were malignant focal lesions, including 15 infiltrating ductal carcinoma,7 intraductal carcinoma, 4 infiltrating lobular carcinoma, 4 ductal carcinoma in situ.18 Benign lesions, including 6 mammary gland disease,6 fiber adenoma, 2 papilloma,4 lobular hyperplasia.2.All participants did MR routine, diffusion and dynamic enhanced check. Observing the morphology and the type of TIC,Calculating the apparent diffusion coefficien values, the exponent diffusion coefficient values,the peak time and the slope of signal intensity-time curve. Then alculating the average value of ADC,rADC,rEADC,EADC,Tmax and SSmax. Pairwise comparison between groups with t-test, count withχ2 test data. Using statistical software SPSS13.0 analysis to determine differences (P<0.05 without statistical significance).Using the receiver-operating curve to determine the threshold diagnosis value of ADC,rADC,rEADC,EADC,Tmax and Ssmax. Results1.Malignant lesions is irregular, leaf edges and the boundary is not clear.Benign lesions is circular, smooth and the boundary is clear. Morphology played a very important role in the diagnosis of breast of lesions,with sensitivity is75.0%,the specificity is 73.3%, the accuracy is 77.8%.2.ADC,rADC,EADC and rEADC value of normal mammary gland,benign lesions and malignant lesions are statistically significant differences among them. The average ADC of normal mammary gland,benign lesions and malignant lesions are (2.01±0.34) mm2/s,(1.56±0.28) mm2/s and (1.09±0.24) mm2/s;The average rADC of benign and malignant lesions are 0.84±0.18 and 0.51±0.22; The average EADC of benign and malignant lesions are 0.11±0.08 and 0.22±0.05;The average rEADC of benign and malignant lesions are 1.33±0.27 and 2.05±0.51;The threshold of ADC value is 1.24 x 10-3 mm2/s, with the sensitivity is 92.9%, the specificity is 81.8%, the accuracy is 88.7%;The threshold of EADC value is 0.29, with the sensitivity is 92.9%, the specificity is 81.8%,the accuracy is 86.0%;The threshold of rADC value is 0.70,with the sensitivity is 85.7%,the specificity is 88.9%,the accuracy is 86.9%;The threshold of rEADC value is 1.68, with the is 80.0%, the specificity is 88.9%, the accuracy is 83.3%.3.There are 2 malignant lesions in typeⅠ, 10 malignant lesions in typeⅡ, 18 malignant lesions in typeⅢ,12 benign lesions in typeⅠ,5 benign lesions in typeⅡ, 1 benign lesion in typeⅢ.TIC curve types of benign and malignant lesions exist statistical differences.Making typeⅡand typeⅢas malignant disease diagnosis standard, the sensitivity is 93.3%, the specificity is 66.7% and the accuracy is 83.3%.4.The average peak time of benign and malignant lesions are (445.0±,40.6)s and (213.4±114.5)s.there are statistically significant differences between benign and malignant lesions.The threshold of Tmax is 396.5s, with the sensitivity is 88.9%, the specificity is 90% and the accuracy is 89.3%. 5.The average slope of signal intensity-time curve of benign and malignant lesions are 5.32±3.04 and 14.66±7.08.There are statistically significant differences between the two.Making Ssmax=8.25 as benign and malignant lesions diagnosis threshold, the sensitivity is 90%, the specificity is 88.9% and the accuracy is 89.6%.6.ADC value co- TIC curve diagnosed benign and malignant lesions well.The sensitivity was 76.7%,the specificity 83.3% and the accuracy is 79.2%.Conclusions1.ADC,rEADC,rADC and EADC of the breast lesion play an important role in diagnosis, the sensitivity and specificity are high.2.The type of time-signal curve,the peak enhanced time and the slope of signal intensity-time curve play an important role in the differential diagnosis of benign and malignant lesions.3.The focal nature of disease of morphological features plays a certain role.4. Diffusion-weighted united dynamic contrast-enhanced help to improve the specificity of diagnosis of the benign and malignant breast lesions.