Dynamic Contrast-enhanced MRI Quantitative Assessment Of Benign And Malignant Breast Lesions And The Correlation With Biological Characteristics Of Breast Cancer

Objective:To explore the diagnostic value of dynamic contrast enhanced Magnetic Resonance Imaging?DCE-MRI?in hemodynamic parameters of lesions and background parenchyma in benign and malignant breast lesions,and the association with molecular subtypes and immunohistochemical indexes of breast cancer.Methods:Data were collected from 92 patients?100 lesions?with breast DCE-MRI in our hospital from January 2016 to October 2016,which benign lesions are 21,malignant lesions are79.Volume transfer constant(K_trans),rate constant(K_ep)and plasma fraction?V_p?of the lesions and background parenchyma were measured,and the parameters of benign and malignant patients were statistically analyzed.To the pathological diagnosis as gold standard,evaluate the efficacy of hemodynamic parameters in the diagnosis of malignant breast lesions.Results:1.K_trans and K_ep of lesions and background parenchyma in the malignant group were higher than those in benign group?P<0.05?.There was no significant difference between V_p of lesions and background parenchyma?P>0.05?.In the diagnosis of malignant lesions,AUC of K_trans of background parenchyma is the higher than others,the sensitivity and specificity is 87.5%and 76.19%,respectively.All parameters combined logistic regression model has the highest AUC value,the sensitivity and specificity is 95.83%and71.43%,respectively.2.K_ep and V_p of ER positive group were lower than those of negative group,the differences were statistically significant?Z=-2.407,-2.676,P=0.016,0.007?.V_p of PR positive group was also significantly lower than that in the negative group?Z=-2.879,P=0.004?.There was no significant difference in the other quantitative parameters between the different expression states of the receptor?P>0.05?.Only V_p were statistically significant in diagnosis different molecular subtypes of breast cancer??²=9.374,P=0.025?.Further comparisons were made between two subtypes,there was statistically significant difference between Luminal A and HER-2+,Luminal A and TNBC?Z=-2.374,-2.276,P=0.018,0.023?.K_trans and K_ep of TNBC were higher than the other three subtypes,but the difference was not statistically significant?P>0.05?.Conclusion:Among the DCE-MRI related parameters,K_trans and K_ep both of lesions and background parenchyma have some diagnostic value for breast diseases,in which the diagnostic value of K_trans of background parenchyma is the highest.K_ep and V_p of different ER expression states of breast cancer are different,and V_p of different PR expression states are different.Luminal A and TNBC,Luminal A and HER-2+can be identified by V_p.Quantitative analysis of DCE-MRI data can help to identify benign and malignant lesions,estrogen and progesterone receptor expression status,and to identify Luminal A,which is the best prognosis,and TNBC,which is the most aggressive.The hemodynamic characteristics is expected to be a new method for non-invasive diagnosis of breast lesions and to influence the clinical treatment.