Application Of Quantitative Enhancement Parameters Of MRI In Different Morphology Of Breast Lesions

Objective To explore the differential between thevalue of dynamic contrast-enhanced MRI quantitative pharmacokinetic parameters and relative pharmacokinetic quantitative parameters in breast lesions.Methods 255 patients who was pathologically confirmed suspected of breast lesions underwent MRI examination.A 3.0T MRI scanner was used to obtain the quantitative MR pharmacokinetic parameters:Ktrans(volume transfer constant),Kcp(exchange rate constant)and Ve(extravascular extracellular volume fraction).And measured the quantitative pharmacokinetic parameters of normal glands tissues which on the same side of the same level of the lesions;and then calculated the value of relative pharmacokinetic parameters:rKtrans,rtep and rVe.To explore the diagnostic value of two pharmacokinetic parameters in differential diagnosis of benign and malignant breast lesions using receiver operating curves and model of logistic regression.Results Finally,there were 253 cases enrolled in a total of 262 lesions into the study,a total of 153 lesions in 150 malignant tumors,and 109 lesions in 103 benign cases.Further more,these lessions were divided into mass-like and non-mass-like enhancement groups,according to the enhanced morphology of breast lesions on DCE-MRI,there were 50 cases in the non-mass-like enhancement lesions totally,contain with 35 malignant and 15 benign.There were 118 cases of mass-like enhancement breast cancer and 35 non-mass like enhancement breast cancer in total.?there were significant differences between benign lesions and malignant lesions in Ktrans and Kep(t=15.489,15.022,respectively,P<0.05),there were no significant differences between benign lesions and malignant lesions in Ve(t=-2.346,P>0.05).The areas under the ROC curve(AUC)of Ktrans Kep and Ve between malignant and benign lesions were 0.933,0.948 and 0.387,The sensitivity of ktrans,krp and Vc were 77.1%,85.0%,51.0%,and the specificity of ktrans,kep and Ve were 96.3%,93.6%,60.8%for the differential diagnosis of breast lesions if taken the maximum Youden'S index as cut-off.?there were significant differences between benign lesions and malignant lesions in rKtrans,rKep and rVe(t=14.177,11.726,2.477,respectively,P<0.05).The AUC of rKtrans,rKep and rVe between malignant and benign lesions were 0.963?0.903 and 0.575,The sensitivity of rKtrans,rKep and rVe were 85.6%,71.9%?52.9%,and the specificity of rKtrans,rKep and rVe were 94.5%,92.7%,60.6%for the differential diagnosis of breast lesions.?There was no significant difference in the area under the ROC curve between the predictive probability of quantitative pharmacokinetic parameters and the prediction probability of relative quantitative pharmacokinetic parameters(Z=0.867,P=0.195).? there were significant differences between benign lesions and malignant of non-mass like enhancement lesions in Ktrans,Kep and relative pharmacokinetic parameters rKtrans?rKep and rVe(t=7.933,8611,8.141,6.558,2.380,respectively,P<0.05),there were no significant differences between NMLE benign lesions and malignant lesions in Ve(t= 0.744,P>0.05).?The value of quantitative MR pharmacokinetic parameters in non-mass like enhancement lesions were higher than that of mass like enhancement lesions,but There was no significant difference between them.Conclusion There was no significant difference between the quantitative parameter values(Ktrans,Kep)and the relative quantitative parameter values(rKtrans,rKep)in diagnosis of breast lesions,which were important parameters in differential diagnosis of benign and malignant breast lesions.