Diagnosis Value Of MRI Quantitative Dynamic Enhancement And IVIM In Breast Lesions With The Tape Of TIC-?

Objective:Quantitative dynamic contrast-enhanced imaging?qDCE-MRI?and intravoxel incoherent motion diffusion weighted imaging?IVIM-DWI?were used to study the diagnosis value of breast lesions of tape TIC-?.The benign and malignant diagnostic value of two techniques in breast lesions of TIC-?were evaluated,their diagnostic efficiency were compared and analyzed to provide more and more effective imaging basis for early and accurate diagnosis of breast cancer.Materials and methods:1?From October 2018 to February 2019,by collect materials in Second Affiliated Hospital of Nanchang University for breast dynamic contrast-enhanced scans,IVIM and diffusion weighted imaging,a total of 39 patients with breast disease were retrospectively analyzed.The data included DCE quantitative parameters(K^trans,K_ep,V_e),semi-quantitative parameters?Maxslope,CER,IAUGC,BAT?,IVIM-DWI parameters(ADC_standard,ADC_slow,ADC_fast,Fraction of ADC_fast)?ADC value of conventional DWI and clinical data.According to admission and exclusion criteria,29 out of 39 cases were eventually enrolled.Surgical treatment was performed in all cases.According to the pathological results,the cases were divided into two groups:There were 21 cases in malignant breast lesions?breast cancer?group,and 8 cases in benign breast lesions group.2?All breast MRI sequences were transmitted to GE image workstation AW4.6for post-processing.Quantitative and semi-quantitative parameters of DCE were measured by Gen IQ software,and IVIM-DWI and DWI data were measured by Functool software,parameters obtained K^trans,K_ep,V_e,Maxslope,CER,IAUGC,BAT,ADC _standard,ADC_slow,ADC_fast,f and ADC.In order to reduce the deviation caused by measurement,Average values of all parameters measured three times as final results.Region of interest?ROI?were avoided glandular margins,blood vessels,fat and necrotic areas as much as possible.3?The data analysis software was SPSS 21.0.P-P chart was used to test the normality of numerical variables?measurement data?among groups.If normal distribution was satisfied,independent sample t test was used to compare the two groups of variables.If not,Mann Whitney U test was used to,then find out the indicators of difference between the two groups of patients by statistical method,the difference between the two groups was statistically significant by P<0.05.According to the statistical results,the diagnostic ability of breast cancer with different parameters was evaluated by using ROC curve.The area under ROC curve?AUC?,sensitivity,specificity,positive predictive value?PPV?and negative predictive value?NPV?were calculated.The accuracy and optimal threshold were determined by Youden index.Results:1.Parameters of DCE-MRI 1.1 Quantitative parametersThe K^transrans value of malignant breast lesions was higher than that of benign breast lesions?P=0.001?.K_epp and V_e values were higher than those of benign lesions,but there was no significant difference?P values were 0.059 and 0.116,respectively?.The area under ROC curve?AUC?was 0.866 with K^transvalue as differential indicators of benign and malignant breast Lesions.The sensitivity,specificity,PPV and NPV were 85.7%?75%?92.3%and 60%respectively with K^transrans value 0.304 as the diagnostic threshold for benign and malignant breast lesions.1.2 Semi-quantitative parametersThe values of Maxslope,CER and IAUGC in malignant lesions were higher than those in benign lesions?P values were 0.004,0.005 and 0.001,respectively?.The BAT value of malignant lesions was slightly higher than that of benign lesions?P=0.358?.The area under ROC curve?AUC?were 0.830,0.871 and 0.821 with Maxslope value,CER value and IAUGC value as differential indicators for benign and malignant breast lesions,respectively.The sensitivity,specificity,PPV and NPV were 75%,87.5%,95.5%and 50%with Maxslope value 0.02755 as diagnostic thresholds for benign and malignant breast lesions,CER value 2.4145 as diagnostic thresholds were 85.7%,75%,92.3%and 60%,IAUGC value 0.331 as diagnostic thresholds were 78.6%,87.5%,91.7%and 50%.AUC of Joint diagnosis of the above parameters was 0.871,sensitivity,specificity,PPV and NPV were 71.4%,87.5%,90.9%and 75%respectively.2.Parameters of IVIM and DWI-ADC value:2.1 Parameters of IVIMThe ADC_standard,ADC_slowlow and f values of malignant lesions were lower than those of benign lesions?P values were 0.003,0.030 and 0.044 respectively?,while the ADC_fastast values of malignant lesions were higher than those of benign lesions?P=0.284?.2.2DWI-ADC valueThe ADC value of malignant lesion group was lower than that of benign lesion group?P=0.019?.The area under ROC curve?AUC?were less than 0.5with ADC_standard,ADC_slow,f and ADC value as differential index of benign and malignant breast lesions.Conclusion:1.DCE-MRI parameters,IVIM-DWI parameters and DWI-ADC values have certain value in diagnosis of benign and malignant breast lesions of TIC-?.2.DCE-MRI parameters are superior to IVIM-DWI parameters and DWI-ADC values in the diagnosis of benign and malignant breast lesions of TIC-?.