Comparative Study Between Dynamic Contrast Enhanced MRI And Diffusion Weighted Imaging And Pathologic In Intraductal Hyperplasia Lesions Of Breast

Objective: To investigate the value of dynamic contrast enhanced imaging and diffusion weightedimaging of MRI and in the diagnosis of the intraductal hyperplasia Lesions of Breast.Methodology:27patients with38lesions proved by histological results were included.Among these cases, DCIS （ductal carcinoma in situ, DCIS） in8cases, lesions8, atypicalhyperplasia （atypical hyperplasia. ADH） in7cases, lesions12（50%mid-severe ADH）,ductal hyperplasia （terminal ductolobularunit, TDLU hyperplasia） in12cases,18lesions. Allcases were underwent by GE SIGNA the HDX, a1.5T superconducting MRI scanner,8-channel breast dedicated phased-array surface coil. All cases were underwent by diffusionweighted imaging. Two different b values （500,1000s/mm²） and thickness of5.0mm.Dynamic contrast enhanced imaging use of GE Vibrant imaging, technology, thickness2.0mm. GD-DTPA contrast agent was administered at a flow rate of2mL/s inject a back ofhand vein.15mL Normal saline was injected at the same rate before and after contrastadministration. Dose for0.2mmol/kg weight. Scanning a phase before the injection ofcontrast agent,and then keep the position constant. Injection of contrast agent, at the sametime continuous interval acquisition phase11, a single scan time of53seconds, the total scantime of9.55min. The original data was put into workstation （GE, ADW4.4） for imageanalysis and pose-processing with software Functool viewer. Selected （region of interest ROI）,try to avoid blood vessels, necrosis, cystic. Measured the ADC values of lesions, observedthe lesions morphology and enhanced features, analyzed the time-intensity curve type andcalculated parameters of dynamic， contrast-enhanced: Smax（%/s）、pH、Tpeak.Results:27patients with38lesions proved by histological results were included. Amongthese cases, DCIS8cases of8lesions, ADH7cases of12lesions,TDLU hyperplasia12cases of18lesions. Only34.21%of intraductal hyperplasia lesions of Breast show high signal or a little high signal in DWI. With b values of500s/mm²and1000s/mm²,the averageADC values of DCTS:（1.483±0.257）×10^-3mm²/s、（1.296±0.239）×10^-3mm²/s,ADH:（1.577±0.276）×10^-3mm²/s、（1.308±0.223）×10^-3mm²/s,TDLU hyperplasia:（1.718±0.190）×10^-3mm²/s�'�（1.462±0.159）×10^-3mm²/s、normal breast tissue：（2.347±0.339）×10^-3mm²/s、（1.902±0.164）×10^-3mm²/s. Among the four only DCISand ADH in two different b values（500,1000s/mm²） were no statistical difference（P>0.05）.T-SI curve of DCIS, I type2/8（25.0%）, II type4/8（50.0%）, III type2/8（25.0%）,T-SI curve of ADH, I type5/12（41.7%）, II type4/12（33.33%）, III type3/12（25.0%）,T-SI curve of TDLU hyperplasia, I type13/18（72.2%）, II type5/18（27.8%）, III type0/18（0%）；Normal breast glandular tissue is low strengthen curve;52.63%T-SI curve of theintraductal hyperplasia Lesions of Breast show I type.The average Smax（%/s） of DCTS:2.285±0.764, ADH:1.840±1.103,TDLUhyperplasia:1.139±0.587. Among the three only DCIS and ADH was no statisticaldifference（P>0.05）.DCIS in the dynamic contrast enhanced imaging performance of irregular shape,line-like, branch-like catheter enhancement and no definite mass.ADH and TDLUhyperplasia performance of distribution line along the catheter direction, points-likestrengthening lesions, some fusion into a film. Normal breast glandular tissue is lowstrengthen curve. MIP：The lesions show clearly, and can reflect the distribution of the lesionand the surrounding vascular relations.Conclusion: a)The larger b value is, the smaller lesions’ ADC value tend to; The smallerlesions’ ADC value is, the more malignant lesions tend to. About34.21%lesions of theintraductal hyperplasia Lesions of Breast show high signal or a little high signal inDWI.Therefore, currently we suggest that if we only rely on DWI, it is difficult to diagnoseof the intraductal hyperplasia Lesions of Breast. b) Dynamic contrast enhanced imaging canprovide a clear morphological information, T-SI curve can reflect the pathological changes ofhemodynamic information. The larger lesions’ Smax（%/s） value is, the more malignantlesions tend to. c) DCIS and precancerous lesions has its own unique morphological imagingfeatures of dynamic contrast enhanced imaging.