| Purpose: To discuss the clinical application of combing MR dynamiccontrast-enhanced T1-weighted magnetic resonance imaging and MRIDiffusion-weighted imaging with T2*-weighted first-pass perfusion resonanceimagingin the diagnosis of breast benign and malignant lesions.Material and Method:We have collected58cases with breast desease,whoreceived surgical operation between2011-6and2012-3in Liaoning CancerHospital.All are female,age between24-72age, Median43age.The postoperativepathology: malignant breast lesions in37cases, including Grade II infiltrating ductalcarcinoma29cases, undifferentiated infiltrating breast carcinoma6cases, infiltratinglobular carcinoma1case, intra-ductal carcinoma1case;benign breast lesions21cases,including fibro adenoma14cases, cystic hyperplasia3cases, intra-ductalpapillomatosis4cases.All the patients have received conventional MR examinationDiffusion weighted imaging（DWI） examination、T2*-weighted first-pass perfusionmagnetic resonance imaging examination and T1-weighted magnetic resonance imagingDiffusion examination.We adopted800s/mm2of the sensitive coefficient value ofDWI,and measured the ADC value in Apparent Diffusion Coefficient Image of postDWI administration. Affte T2*-weighted first-pass perfusion magnetic and dynamiccontrast-enhanced T1-weighted magnetic resonance imaging,we drew the time-signalintensity curve of T2*-weighted first-pass perfusion magnetic resonance imaging anddynamic contrast-enhanced T1-weighted magnetic resonance imaging with GEAdvantage Workstation Version4.3functional software. With the gold standard ofpathological diagnosis.we summarize the imaging features of the benign and malignantlesions through dynamic contrast-enhanced T1-weighted magnetic resonance imaging, Diffusion weighted imaging and T2*-weighted first-pass perfusion magnetic resonanceimaging;we analyzed Statistics difference of benign and malignant lisines in dynamiccontrast-enhanced T1-weighted magnetic resonance imaging time-signal intensitycurve、Diffusion Coefficient Image apparent diffusion coefficient and T2*-weightedfirst-pass perfusion magnetic resonance imaging time-signal intensity curve. weanalyzed Statistics difference of benign and malignant lisines in dynamiccontrast-enhanced T1-weighted magnetic resonance imaging time-signal intensitycurve,which appeared flatform curve in dynamic contrast-enhanced T1-weightedmagnetic resonance imaging. we analyzed Statistics difference of benign and malignantlesions in dynamic contrast-enhanced time-signal intensity curve of T1-weightedmagnetic resonance imaging,which appeared flatform curve in Diffusion CoefficientImage apparent diffusion coefficient.We summarize the sensitivity, specificity,accuracy,positive predictive value and negative predictive value of combining dynamiccontrast-enhanced T1-weighted magnetic resonance imaging and Diffusion CoefficientImage with T2*-weighted first-pass perfusion magnetic resonance imaging in thediagnosis of breast disease.we adopted SPSS17.0statistical software, the quantitativematerral average ADC values represent as （mean±sd）.we apply t test, X2test andFisher ’s exact probability statistical methods respectively.Results:Among all the cases in this studied group with dynamic contrast-enhanced T1-weighted magnetic resonance imaging,21cases benign breast disease,5cases lobulated shape;13cases round shape;3cases irregular shape.16cases smoothmargin,4cases irregular margin, and only one case spinelet margin.;On the other side,37cases malignant breast disease,7cases lobulated shape,14cases round shape;16cases irregular shape. On the marginal form, only5cases smooth margin,10casesirregular margin, and22cases spinelet margin. Among all the cases in this studiedgroup with time-signal intensity curve of dynamic contrast-enhanced T1-weightedmagnetic resonance imaging, benign21cases breast disease,11cases Type I curve,9cases Type II curve, and1case Type III curve; of37cases malignant breast disease,1case Type I curve,11cases Type II curve, and25cases Type III curve.The benign andmalignant breast lesions showed significant statistic differences in the T1WI dynamicenhance imaging TIC curve （p<0.01）. Among the cases in studied group withDWI,1.010x10-3mm2/s as threshold of benign and malignant lesions, we diagnosed26cases benign lesions and32cases malignant lesions on basis of ADC value. Thereare greatly statistic difference in ADC value of DWI in the breat benignand malignant lesions（p<0.01）. All the cases in this group in T2*-weighted first-pass perfusionmagnetic resonance imaging time-signal intensity curve,among21benign cases,type A7cases,type C6cases,type D8cases;37cases malignant breast disease, type A31cases, type B4cases, type C1cases, type D1cases.There is significant statisticdifferences of benign and malignant lesions in time-signal intensity curve ofT2*-weighted first-pass perfusion magnetic resonance imaging （p<0.01）.In dynamiccontrast-enhanced T1-weighted magnetic resonance imaging curve, flapform typebenign lesions9cases, flapform type malignant lesions11cases,there is significantstatistic differences in DWI imaging and dynamic contrast-enhancedT1-weightedmagnetic resonance imaging（p<0.01）.We evaluate breast lesions withdynamic contrast-enhanced T1-weighted magnetic resonance imaging、 DiffusionCoefficient Image and T2*-weightedfirst-pass perfusion magnetic resonance imaging. Sensitivity97.30%,specificity85.71%, accuracy93.10%, positive predictive value92.31%, negativepredictive value94.12%.Conclusion:It is of significantly clinical application value that we diagnosis breastlesions with Diffusion-weighted imaging magnetic resonance, dynamic contrast-enhanced T1-weighted magnetic resonance imaging, or T2*-weighted first-passperfusion magnetic resonance imaging separately.It is of significantly clinicalapplication value that we diagnosis breast lesions with DWI and T2*-weighted first-passperfusion magnetic resonance imaging,which appear non-typical in dynamic contrast-enhanced T1-weighted magnetic resonance imaging.Combing Diffusion-weightedimaging magnetic resonance andT1*WI dynamic enhanced imaging with T2*-weightedfirst-pass perfusion magnetic resonance imaging,we can greatly improve the diagnosisaccuracy in the diagnosis of breat lesions. |
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