The Value Analysis Of MR Multiparameter Imaging On Benign And Malignant Breast Lesions

Part ?:Diagnostic efficiency of MR multiparameter imaging and its joint on benign and malignant breast lesionsObj ective:To explore the diagnostic value of conventional Magnetic resonance imaging(MRI),dynamic enhanced scanning(DCE)and diffusion-weighted imaging(DWI)alone and multiple parameters in MR multi parameter imaging for benign and malignant breast lesions.Materials and methods:To collect the First Affiliated Hospital of Bengbu Medical College from January of 2015 to December of 2017,and clinical palpation was found in breast nodules or lumps,and 59 female patients were confirmed by puncture or surgical pathology,with a total of 67 lesions(35 malignant lesions and 32 benign lesions).All patients with conventional MRI,dynamic enhanced scan and diffusion weighted imaging(b = 800 s/mm2)scans.Observe and analyze the morphological features of conventional MRI dynamic enhancement scanning time-signal intensity curve drawing(DCE-TIC)and measuring the apparent diffusion coefficient of diffusion weighted imaging(DWI-ADC).Use Chi square test for MR morphological manifestations and DCE-TIC curve type,and independent sample t test for ADC.Analyze the difference of morphological features,TIC curve and ADC of between benign and malignant breast lesions have or not have statistical significance,ROC curve is adopted to define ADC values to identify the diagnosis of benign and malignant lesions,and qualitative diagnosis of lesions;Multiparameter combined use of grading method according to the score for the qualitative diagnosis of lesions.Finally according to the pathological result as the gold standard,and evaluate the diagnostic efficiency of MR morphology,DCE-TIC and DWI-ADC values and its joint application on benign and malignant breast lesions.Results:MR morphology in the diagnosis of benign and malignant breast lesions of the sensitivity is 97.1%,specificity is 70.0%,positive predictive value is 80.9%,negative predictive value is 96.0%,accuracy is 86.6%and Kappa is 0.728.DCE-TIC in the diagnosis of benign and malignant breast lesions of the sensitivity is 94.3%,specificity is 71.9%,positive predictive value is 78.6%,negative predictive value is 92.0%,accuracy is 83.6%and Kappa is 0.668.ROC curve analysis is adopted to define ADC values to identify the diagnosis of benign and malignant breast lesions and the threshold is 0.976×10-3mm2/s;DWI-ADC values diagnostic sensitivity is 85.7%,specificity is 90.6%,positive predictive value is 90.9%,negative predictive value is 85.3%,accuracy is 88.1%and Kappa is 0.761.MR morphology combined DCE-TIC diagnostic sensitivity is 94.3%,specificity is 90.6%,positive predictive value is 91.7%,negative predictive value is 93.5%,accuracy is 92.5%and Kappa is 0.850.DCE-TIC joint DWI-ADC values diagnostic sensitivity is 94.3%,specificity is 90.6%,positive predictive value is 91.7%,negative predictive value is 93.5%,accuracy is 92.5%and Kappa is 0.850.MR morphology,DCE-TIC joint DWI-ADC values diagnostic sensitivity is 94.3%,specificity is 90.6%,positive predictive value is 91.7%,negative predictive value is of 93.5%,accuracy is 92.5%and Kappa is 0.850.Conclusion:?MR morphology and DCE-TIC separate diagnostic sensitivity is higher,but the specificity is all low,the diagnostic specificity is enhanced by joint applicantion of them,and provide further reliable diagnostic basis for qualitative diagnosis of lesions.? DWI-ADC values diagnostic sensitivity and specificity of identifying benign and malignant breast lesions is high,and the individual diagnosis can provide reliable basis.ROC curve analysis showed that the threshold value of ADC is 0.976×10-3mm2/s.?MR morphology,DCE-TIC and DWI-ADC values can combined application to identify the diagnosis of benign and malignant breast lesions efficiency is better(AUC)0.924 than ether.Part ?:The Correlation analysis between MR apparent diffusion coefficient and prognostic factors of invasive ductal carcinoma of the breastObjective:To explore the correlation between the value of MR apparent diffusion coefficient(ADC)and the prognostic factors of breast infiltrating ductal carcinoma(IDC).Materials and methods:Select the first portion of the study,32 cases of female patients with breast infiltrating ductal carcinoma(IDC)were confirmed by pathology,ranging from 27 to 76 years old,with an average age of 46.69 ± 9.31 years.In all patients,MR diffusion weighted imaging was performed,and the histological classification standard,which was proposed by Elston and Ellis modified Bloom-Richadson(1957),was classified into three levels.The difference of ADC values between different pathological grades was compared by single factor variance analysis,and the correlation was analyzed by Spearman rank correlation.The axillary lymph node metastasis was divided into positive and negative groups.The mass size was divided into two groups by 2cm.The difference between ADC calues and axillary lymph node metastasis and mass size was statistically significant with two independent sample t test.Pearson correlation analysis was used to analyze the correlation between ADC values and age.Results:The average ADC calues of the pathological grade ? of invasive ductal carcinoma of the breast(IDC)is(1.066±0.231)×10-3mm2/s,and the average ADC values of grade ? is(0.792 + 0.155)×10-3mm2/s,and the average ADC values of grade? is(0.686 ± 0.059)×10-3mm2/s,using the single factor analysis of variance was statistically significant difference between the pathologic stage groups(F = 7.652,p<0.01);LSD multiple comparison was used to compare the comparison of pathological grades in the group,and the difference of average ADC values between grade ? and??? was statistically significant(p<0.05),there is no statistically significant difference between grade ? and ?(p>0.05);Spearman rank correlation analysis showed that the ADC values is negatively correlated with the pathological grade of IDC.Spearman rank correlation analysis showed that ADC values of breast infiltrating ductal carcinoma was negatively correlated with pathological grading(r=-0.535,p=0.002<0.05).There is no significant difference between ADC values and axillary lymph node metastasis and tumor size(p>0.05).Pearson correlation analysis showed that there is no significant correlation between ADC values and age(r=-0.025,p=0.893>0.05).Conclusion:? The difference between ADC values and breast infiltrating ductal carcinoma(IDC)was statistically significant and negatively correlated.ADC values can predict the degree of tumor differentiation of IDC and have reference value for the diagnosis of breast cancer pathology grade.? There is no significant correlation between the ADC values and the axillary lymph node metastasis and the size,age and other prognostic factors of IDC.