Study Of Combined 3.0T MRI New Technique And Mammograms In Breast Benign And Malignant Lesion

Objective:To investigate the diagnostic value of Mammography, 3.0T MRI new technique(Dynamic Contrast-Enhanced Magnetic Resonance Imaging, Diffusion Weighted Imaging and Magnetic Resonance Spectroscopy) and combining mammography with magnetic resonance imaging for benign and malignant breast lesions.Methods:(1)Sixty-one breast lesion patients proved by surgery and postoperative pathology were collected between November 1st, 2013 and September 30 th, 2014 from Affiliated Hospital of Zunyi Medical College, Age range 23-77 years, mean age 44.8 years, mammography and magnetic resonance imaging were performed in all patients.47 cases were malignant, 14 cases were benign. Imaging findings were observed and analyzed for all cases, including lesion shape, calcification, lymph node metastasis, enhancement pattern, DWI signal, TIC type, ADC values and whether the choline peak was detected on MRS.(2)The MRI new technique(DWI, TIC and MRS) were analyzed whether there was difference between benign and malignant breast lesions in diagnostic sensitivity, specificity and accuracy, the positive predictive value and negative predictive value, whether there were differences in the diagnostic value of benign and malignant breast lesions using only mammography, MRI and combining mammography with MRI. Count data was conducted with chi square test. Statistical analyses were performed by SPSS17.0 version, p<0.05 was considered as a statistically significant difference.Results:(1)The value of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of breast disease was accounted for up to 61.1%, 93%, 83.6%, 78.6% and 85.1%, respectively, which were based on the morphologic feature. Chi-square test(χ2=1) was p>0.05, the diagnostic values of lesions shape in malignant lesions wasn’t statistically different.(2)Using time-signal intensity curve as the diagnostic criteria of malignant lesions, the(2)Using time-signal intensity curve as the diagnostic criteria of malignant lesions, the value of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value was up to 100%, 88.7%, 90.1%, 57.1% and 100%, respectively. According to the value of χ2(χ2= 4.17), type II and type III curve as the diagnostic criteria of malignant breast lesions was statistically significant difference(p<0.05).(3)The area under the ROC curve of ADC values of malignant lesions and the contralateral normal breast tissue was 0.988, with 1.210×10-3mm2/s as a threshold of differential diagnosis in benign and malignant breast lesions, of 47 cases malignant lesions, there were 44 cases ADC<1.210×10-3mm2/s, the value of sensitivity, specificity and accuracy value was up to 82.6%, 84.4%, 86.9%, respectively.(4)Choline peak was considered as breast malignant lesions, the value of sensitivity, the specificity, the accuracy, the positive predictive value, the negative predictive value was up to 70.2%, 70.6%, 75%, 97.1% and 17.6%, respectively, There is statistically significant difference between the two groups(p<0.05).(5)For differential diagnosis between benign and malignant breast lesions of three new techniques, the sensitivity and accuracy of dynamic enhancement and DWI were 100%, 90.1% and 82.6%, 86.9%, respectively, which was higher sensitivity and accuracy, however, MRS had higher specificity in diagnosis between the benign and malignant breast lesions compared with dynamic enhancement and DWI.(6)Two breast diagnostic radiologists respectively used mammography and MRI diagnosis of benign and malignant breast lesions. The data provided by two breast diagnostic radiologists was conducted with Kappa test, MR imaging was superior to mammography for making a differential diagnosis in benign and malignant breast lesions.(7)The accuracy were 45.9% and 62.3% respectively when radiologists used mammography or new technologies of MRI as a sole method for the diagnosis of benign and malignant breast disease. When combining two techniques, the coincidence rate was 80.3%. The coincidence rate based on combining mammography and MRI were higher than on basis of a kind of examination in benign and malignant detection, which showed a statistically significant difference(p<0.05).Conclusion:MRI examination was superior to mammography for the diagnosis value of benign and malignant breast lesions. Time-signal intensity curve, ADC values were more sensitive in the diagnosis of breast cancer, whereas MRS was more specific in positive predictive value of breast cancer. Combining mammography with MRI examination can not only obviously improve the accuracy of preoperative diagnosis of breast cancer but also provide the theoretical basis for the early diagnosis and prognosis.