| ObjectiveTo explore the value of differential diagnosis of benign and malignant breast massusing two methods together. Combined the Ktrans value method with Fischer scoremethod to evaluate benign and malignant breast tumors through dynamic measurement inbreasts.Materials and Methods50breast masses were collected from The Shandong Medical Imaging Institute duringthe period January2013to Feberary2014, all of the patients were female, and confirmedby surgery or pathology, the pathological results which including31cases of benign breastmass,19cases of breast malignant tumor. The newest magnetic resonance preoperatively(Siemens skyra3.0T superconducting magnetic resonance scanner)be used with breastroutine MR examination and quantitative dynamic enhanced MR examination, after theinspection, all scanned images are in the Siemens company dedicated workstation based onTissue4D software which is the post protocol. Drawing the region of interest, thenmeasuring Ktrans corresponding to each case values to judge the benign and malignantbreast tumors. The two qualification in subtropical or senior doctors using Fischer scoreand morphology of breast tumor diagnosis to determine the benign or malignant about ofthe tumor, when two people have a different opinion,they will negotiation until get toagree a coherence result, then two people after the summary views to identify which isbenign or malignant tumors. Finally, through the quantitative dynamic enhanced Ktransvalue to judge results and by the Fischer score were obtained the final pathology results,Using the statistical method to calculate the two methods for the diagnosis of breast tumorspecificity, sensitivity, false positive rate and false negative rate, the combined application of two methods to calculate the specificity, sensitivity, false positive rate and false negativerate, and compared with the three results.ResultThe obtained data were analyzed with SPSS15.0software package, using T-test(t=6.418，P<0.05),ROC curve, Rank sum test(Z=-5.334，P<0.05), χ2-test(χ2=41.871，P<0.05),exist statistics significance differences. Ktrans, which was obtained by thedynamic contrast enhanced MRI, was valued to distinguish of benign and malignant breastmasses,the specificity80.65%,sensitivity84.21%, false positive rate19.35%,and falsenegative rate15.79%. Fischer scoring method was valued to distinguish of benign andmalignant breast masses, the sensitivity96.77%, sensitivity78.95%, false positive rate3.23%,and false negative rate21.05%. combined Ktrans value with Fischer score to judgebenign or malignant breast masses, the sensitivity96.77%, sensitivity94.74%, falsepositive rate3.23%,and false negative rate5.26%. Breast dynamic contrast enhancedKtrans value judgment of benign and malignant breast tumors with higher sensitivity,Fischer score from morphology to judge the benign and malignant breast tumors withhigher specificity, combined with the two techniques in diagnosis of breast mass,both ofsensitivity and specificity were greatly increased.ConclusionThe value of dynamic contrast-enhanced Ktrans of the breast is mainly to judge thebenign and malignant breast tumors through the hemodynamics of quantitative analysis ofmass and its surrounding the blood supply and the microvascular permeability,and theFischer score is mainly to judge the benign and malignant breast tumors through the mainlesions of the shape, size, boundary and morphological observation. There are advantagesabout two methods for determining lesion has, but also disadvantages, by differences intheir sensitivity, specificity, accuracy can be read. Therefore, depending on which methodin diagnosis of lesions not single, combining the two complementary advantages cangreatly improve the accuracy of diagnosis of breast masses, can serve for clinical betterand get the qualitative early diagnosis of masses can be more reasonable treatment ofbreast masses, can effectively improve the survival rate of patients and improve the life qualityof the patients. |
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