The Value Of MR Diffusion Weighted Imaging And Apparent Diffusion Coefficient Value In Differential Diagnosis Of Breast Benign And Malignant Lesions

Objective: To evaluate the value of apparent diffusion coefficient (ADC)and relative apparent diffusion coefficient (rADC) of diffusion weightedimaging (DWI) in the diagnosis of patients with breast diseases.Materials and methods: This was a prospective study of the diagnosticvalue of MR diffusion weighted imaging in differential diagnosis of breastlesions. According to the study inclusion criteria:(1) patientsclinically diagnosed breast benign or malignant tumors;(2) surgery orcore needle biopsy in our hospital and achieve pathology results afterMRI examination;(3) without breast biopsy and other interventionmeasures before MRI examination;(4) lesion cross-sectional area largerthan or equal to25mm2;(5) fibrous glandular tissue of the breast withACR type II-IV (the volume of fibrous glandular tissue larger than or equalto25%),220patients who had a preoperative breast MRI examinationincluding DWI scanning (b=800s/mm2) were recruited into this study. TheADC values and the rADC values of the breast lesions, contralateralpectoralis major muscle, ipsilateral and conralateral normal breasttissue were measured and calculated. The result of rADC1was equal to thelesion’s ADC divided by the ADC of the contralateral normal breast tissue.The result of rADC2was equal to the lesion’s ADC divided by the ADC ofthe contralateral pectoralis major muscle. Seek optimal threshold valueof ADC and rADC, and compare the diagnostic value. Results:220lesions were confirmed by pathology, including105benignlesions and115malignant lesions. The threshold of lesion ADC value was1.20x10-3mm2/s, with the area under the curve of0.923, a sensitivity of88.7%, a specificity of87.6%, and the diagnostic accuracy of88.2%. Thethreshold of lesion rADC1value was0.70, with the area under the curveof0.834, a sensitivity of82.6%, a specificity of70.9%, and thediagnostic accuracy of80.9%. The threshold of lesion rADC2value was0.81,with the area under the curve of0.873, a sensitivity of83.5%, aspecificity of78.1%, and a diagnostic accuracy of81.0%.Conclusion: ADC value and rADC value have a high value in the diagnosisof breast diseases. With the same b value, the specificity of the lesion’s ADC value was higher than the one of rADC value. There was no significantdifference for the specificity between them. Pectoralis major musclebeing as a reference, its diagnostic value was equal to the normal breasttissue as reference. Objective: To investigate the diagnostic value of diffusion weightedimaging and apparent diffusion coefficient in breast inflammatory diseases and breast cancer, and improve differential diagnosis betweenthem.Materials and methods: This study reviewed32patients with breastinflammatory diseases and45patients with non-mass like enhanced breastcancer, confirmed by core needle biopsy (n=12) or surgical excision (n=65).All the patients underwent MRI, including DWI scanning. Aanalysis of themorphology, signal intensity, and ADC value were performed.Results: All the inflammatory diseases were detected on DWI, including23patients with abscesses or micro-abscesses. They showed heterogeneoushigh signal intensity, partially remarkable heperintensity, all thelesions had clear margins. High signal intensity on DWI and STIR was morelikely to be seen in breast inflammatory diseases than breast cancer(P<0.01）. Breast cancer mostly showed a high signal intensity on DWI anda slightly low signal intensity on STIR (P<0.01）. The average ADC valueof inflammatory exudation or granulomatous tissues (n=32) was1.48±0.21x10-3mm2/s, the average ADC value of abscesses or micro-abscesses(n=23) was0.91±0.19x10-3mm2/s. The average ADC value of breast cancer(n=45) was1.15±0.23x10-3mm2/s.Conclusion: ADC value from DWI combining with STIR has a high value indifferential diagnosis between non-lactating breast inflammatory diseaseand breast cancer. Abscesses have typical characteristics on DWI.