Evaluation Of The Value Of Multimodal Functional MRI In The Diagnosis Of Benign And Malignant Breast Lesions

Objective:The aim of this research was to explore the role of multimodal functional magnetic resonance imaging in the diagnosis of breast diseases and the differential diagnosis of benign and malignant lesions,including diffusion weighted imaging?DWI?,dynamic contrast-enhanced magnetic resonance imaging?DCE-MRI?and magnetic resonance spectroscopy?MRS?.Materials and methods:This study included 135 patients with breast diseases?135 lesions in total?of female patients suffering from breast diseases from December2017 to December 2018 in the 900^th hospital of the PLA joint logistic support force,the machine used in this study was Siemens Magnetom Skyra 3.0T magnetic resonance and the coil used was 4-channel phased-array surface coil for breast.All patients underwent DWI,MRS and dynamic enhanced scanning,and all data were measured and processed by the machine's own workstation.Finally,the results were analyzed by SPSS21 software.DCE-MRI determines benign and malignant lesions by analyzing morphological manifestations?shape,edge,enhancement mode?and TIC curves.The ROC curves were constructed for the differential diagnosis of benign and malignant breast lesions by calculating the I?Cho?/I?Water?and ADC values of benign and malignant breast lesions,the thresholds were determined and the area under the curve?AUC?was calculated.With the pathological results as the gold standard,the sensitivity,specificity,positive predictive value?PPV?,negative predictive value?NPV?,accuracy and AUC of DCE-MRI,MRS and ADC values and their combination were calculated and analyzed in the diagnosis of benign and malignant breast lesions.The test level for this study was 0.05.Results:In 135 case of this study,43 were benign,92 were malignant,the size of the lesion varied from 1.0 to 11.9 cm.The results of DWI showed that the range of ADC values for benign group was(1.140±0.280×10^-3mm²/s),and that for malignant group was(0.785±0.173×10^-3mm²/s).The latter was significantly lower than the former,and there was a statistical difference between the two groups.The optimal threshold obtained by ROC curve is 1.079×10^-3mm²/s,with a high sensitivity?97.8%?and a low specificity?69.8%?,the accuracy was 88.9%and the AUC was 0.850.In DCE-MRI analysis,95 patients were diagnosed as malignant,40 were benign,the sensitivity,specificity,and accuracy of the diagnosis of DCE were 95.7%,83.7%,90.0%,In addition,AUC was 0.897.The results of semi-quantitative MRS showed that the ratio of I?Cho?/I?Water?ranges from 0 to 62.9 in benign lesion and 0 to382.45?median 10.565?in malignant lesion,the value of the malignant group was higher than that of the benign group,and there was a statistical difference between two groups.The optimal threshold obtained by the ROC curve is 5.99,the sensitivity,specificity,and accuracy were 68.5%,65.1%,and 67.4%,AUC was 0.729.Combining three parameters,the sensitivity,specificity,and accuracy of the diagnosis were96.7%,81.3%,91.9%,AUC was 0.891.DCE is the most effective technique among the three parameters and MRS is the least one.Combining the advantages of the three techniques,which can improve the diagnostic efficiency in general.Conclusion:Multimodal functional magnetic resonance imaging plays an important role in the diagnosis of benign and malignant breast lesions.The advantages of the three techniques combined can improve the diagnostic efficiency.