The Correlations Of Background Parenchymal Enhancement On Dynamic Contrast-enhanced MRI With The Risk Of Breast Cancer

Objective To investigate the correlations of background parenchymal enhancement(BPE)on dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)with the risk of breast cancer and the mammographic density(MD)on digital mammography(DM).Methods A total of 159 cases of breast disease confirmed by histopathology were recruited.Digital mammography and breast MRI were performed in all patients.Craniocaudal and mediolateral oblique position were conducted by digital mammography(Inspiration,Siemens,Germany).Breast MR imaging was obtained on a 3T MRI scanner(Magnetom Verio,Siemens,Germany)with 16 channel phase array coil.The MR sequences included fat unsuppressed T1 weighted imaging(T1WI),fat suppressed T2 weighted imaging(T2WI),Turbo inversion recovery magnitude(TIRM),diffusion weighted imaging(DWI),and DCE-MRI.All images were independently read by two senior doctors with six years of experience in breast MRI.DM-MD,BPE manifestations,and time-intensity curve(TIC)were observed in patients with benign and malignant mammary gland disease.Chi-square was used to detect the difference of BPE manifestations,DM-MD imaging and TIC in patients with benign and malignant mammary gland disease;Consistency test was used to detect the manifestations of BPE,the image of DM-MD,TIC conditions and pathologic analysis,and the ROC curve was drawn.To observe the difference of DM-MD imaging,TIC and menstrual situation of different BPE,the factors of BPE were analyzed by binary regression analysis.Result Of the 159 patients with breast disease,there were 97 malignancies and 62 benign.The Chi-square results showed that BPE manifestations had significant differences in patients with benign and malignant breast disease(?2=1 12.537,P=0.000);The Consistency test results showed that the results of BPE were good consistent with the pathological results(Kappa=0.839,P=0.000);The ROC curve results showed that the AUC value of BPE was 0.912 for benign and malignant breast disease.The Chi-square results showed that DM-MD had no significant differences in patients with benign and malignant breast disease(?2=0.520,P=0.471);The Consistency test results showed that the results of DM-MD were not consistent with the pathological results(Kappa =0.042,P=0.A71);The ROC curve results showed that the AUC value of DM-MD was 0.513 for benign and malignant breast disease.The Chi-square results showed that TIC manifestations had significant dififerences in patients with benign and malignant breast disease(?2= 1.065,P=0.000);The Consistency test results showed that the results of TIC were bad consistent with the pathological results(Kappa=0.206,P=0.000);The ROC curve results showed that the AUC value of TIC was 0.867 for benign and malignant breast disease.The ROC curve results showed that BPE diagnosis AUC was significantly better than DM-MD(Z = 12.681,P= 0.000),TIC(Z = 3.498,P= 0.001).(?2=112.537,F=0.000).DM-MD had no significant difference in different BPE patients(?2=2.620,P=0.106);TIC had significant differences in different BPE patients(?2=123.329,P=0.000);Menstrual conditions had significant differences in different BPE patients(?2=4.206,P=0.040).The results of binary regression analysis show that the TIC classification is highly consistent with the results of BPE.Conclusions The increase of BPE on DCE MRI may increase the risk of breast cancer.There is no significant correlation between BPE and DM-MD.BPE correlates with the situation of menopause which may be related with the changes of hormone.