| ObjectiveBreast disease was various, the incidence of benign,malignant and inflammatory diseases were high,but how to make final diagnosis and differential diagnosis were difficult.Our purpose of this study was exploring the feature of breast inflammatory affection in MR dynamic contrast-enhanced(DCE-MR) sequence, to elevate it's final diagnosis rate and differential diagnosis ability.Methods44 cases identified by histopathology underwent plain MRI and dynamic contrast-enhanced MR scan, including 24 cases of breast inflammatory affection and 20 cases of breast cancer. The MRI signs were analyzed:containing signal intensity, morphology of plain scan and features of DCE-MR. Drew time-signal intensity curve(TIC) by Siemens 3.0T MR (syngo) post-processing workstation. Calculated early enhancement ratio (EER), time to peak (Tpeak), maximum enhancement ratio (Emax), maximum signal intensity (SImax).Counted the diagnostic sensitivity, specificity, accuracy, positive predictive value of breast inflammatory affection.Results24 cases of breast inflammatory affection with varying numbers of lesions:7 cases of acute mastitis,6 cases of chronic mastitis,9 cases of mammary duct ectasia,2 cases of TB.20 cases of breast cancer including 20 lesions. All breast inflammatory:6 cases(25%) were not fond in plain scan,1 case(4.2%) of TB showed several nodules with equal signal intensity on T1WI and T2WI.17 cases(70.8%) appeared localized or diffused uneven signal, slightly low signal intensity on T1WI and slightly high on T2WI.8 cases had abscesses with gland derangement, pachyderma, chest wall dropsy, the armpit lymphadenectasis. One TB had even nodules with evident enhancement,23 cases showed non-entity enhancement:cord, plaque-like (2/24), partitioning(4/24),mottling or patching, circular(11/24),chaplet form(6/24).20 cases of breast cancer:5 cases (25%) were not fond,15 cases(75%) showed mass-like shape with slightly low signal intensity on T1WI and slightly high on T2WI.4 cases (20%) appeared oval,16 irregular or lobule shape(80%) after enhancement.14 cases(70%) had glitch sign or astral sign,9 cases(45%) performed uneven enhancement,11 cases (55%) ring form enhancement. Features of hemodynamic:the EER, Emax of acute mastitis,chronic mastitis compared with mammary duct ectasia having significant differences (P<0.05), EER was:2.33±0.45,2.44±0.51,1.48±0.32,Emax:3.12±0.48,3.11±0.31,2.61±0.36. Tpeak,SImax and all parameters of hemodynamic in both acute mastitis and chronic mastitis had no significant differences (P>0.05). TIC of Mammary duct ectasia were mostly typeⅠ(6/9), While the acute mastitis and chronic mastitis appeared mostly typeⅡ(13/15). The EER, SImax, Emax of breast cancer:1.90±0.61,579.78±67.95, 2.33±0.57,were lower than breast inflammatory affection(P<0.05).TIC showed typeⅡandⅢ(p<0.05). Set the lower bound of 95%confidence interval of the inflammatory affection lesions'EER, Emax, SImax values as differential level, the sensitivity were:55.6%,72.2%,50%, specificity:65.6%,78.1%,100%, accuracy: 62%,76%,82%,and positive predictive value:72.4%,83.3%,78%.Emax had the greatest value。ConclusionMRI of breast inflammatory affection has certain characteristics. Plain MR combined its'morphology and hemodynamic characteristics can help the differential diagnosis. Dynamic contrast-enhanced MRI has great value in breast inflammatory affection. |
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