| Objective:To investigate the clinic application value of 3. OT MR dynamic contrast enhancement (DCE) in differentiation between benign and malignant breast lesions. Methods:65 cases pathologically proven by operation or biopsy were undertaken 3. OT MR breast dynamic contrast enhancement.39 patients underwent X-ray mammography simultaneously. Morphological feature and DCE manifestation between benign and malignant breast lesions was evaluated and statistical difference was compared. Morphological feature included size, contour, margin, edema, signal intensity of non-enhancement, homogeneous or heterogeneous enhancement, internal enhanced septum and tumor vessel. DCE analysis contained time-intensity curve (TIC), initial enhancement ratio, signal intensity and increasing value of signal intensity after enhancement. Classification was made according BI-RADS in mammography and MRI respectively and their diagnostic accuracy were compared. Result:64 cases were detected while 1 DCIS was not found on MRI. There was statistical difference between benign and malignant breast lesions in morphological feature except size, contour and signal intensity. TIC had statistical significance in differentiation between benign and malignant breast lesions while there was no statistical difference in initial enhancement ratio. Statistical difference was found in signal intensity and increasing value of signal intensity after enhancement.10 cases were diagnosed erroneously while 1 case was missed diagnosis. The sensitivity, specificity and diagnostic accuracy of TIC was 85.3%,66.7% and 76.6%, respectively. The value increased to 88.2%,80% and 84.3% combining with morphological feature. Conclusion:TIC is valuable in differentiating the malignant lesions from the benign. The diagnostic efficacy improve conspicuously combining with morphological feature. Optimal examination opportunity should be selected and other detection methods combined with in order to avoid incorrect or missed diagnosis. Objective:To investigate the clinic application value of 3. OT MR diffusion weighted imaging (DWI) in differentiation between benign and malignant breast lesions. Methods:65 cases, including 30 benign and 35 malignant lesions, pathologically proven by operation or biopsy were undertaken DWI on 3. OT MR. Three b values of 50,450 and 850 s/mm2 were used. Apparent diffusion coefficients (ADC value) were measured in normal tissues, benign and malignant lesions and statistical difference was compared among three groups. ROC was deduced to compare the diagnostic efficacy of different b values. ADC value of mass-like lesion, nonmass-like lesion, carcinoma in situ and invasive cancer were statistically analyzed. DWI manifestation of mucinous cancer was evaluated. The ADC value of abscess and necrotic or cystic area of breast cancer was compared. The diagnostic efficacy was calculated by combining DCE and DWI. Result:62 cases were detected while 3 cases of ductal carcinoma in situ was not found on DWI, with the detection rate of 95.4%. There was statistical difference among normal tissues, benign and malignant breast lesions. With b value of 850-50s/mm2, the sensitivity, specificity and diagnostic accuracy was 87.5%,83.3% and 85.5%, respectively, when the threshold of ADC value was set at 1.098×10-3mm2/s. There was statistical difference between mass-like lesion and nonmass-like lesion, carcinoma in situ and invasive cancer, respectively. The ADC value of mucinous cancer was higher than that of normal tissues. Abscess had lower ADC value than necrotic or cystic breast cancer. Combining DCE and DWI, the sensitivity, specificity, diagnostic accuracy could reach 91.4%,86.7% and 89.2%. Conclusion:The mean ADC value of malignant lesion is lower than that of benign lesion. DWI is helpful in differentiating the malignant lesions from the benign on 3. OTMR with a threshold of 1.098×10-3mm2/s when b value is set at 850-50s/mm2. DWI is an important adjunct method which can improve diagnostic efficacy conspicuously by combining with DCE. |
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