The Diagnostic Value Of DCE Combined With DWI For Benign And Malignant Breast Tumors

Objective Through breast dynamic enhanced magnetic resonance（dynamic contrast enhancement MRI,DCE MRI）and diffusion weighted imaging（coursing together weighted imaging,DWI）can contrast,discusses dynamic enhanced MRI quantitative parameters(K^trans,K_ep,V_e)for breast lumps of benign and malignant diagnosis value;To explore whether the combination of dynamic enhanced quantitative parameters and Apparent diffusion coefficient（ADC）can improve the diagnostic efficiency of the diagnosis of benign and malignant breast tumors.Methods Collection the Zhejiang Chinese Medical University the third affiliated hospital from November 2015 to December 2015,because of the ultrasound or physical touch found lumps in breast MRI,and a week adept breast biopsy or surgical pathology results,incorporating them into this study.Object of this study are women,collected a total of 26 cases,16 cases of malignant group（11 cases infiltrating ductal carcinoma,mucinous carcinoma 2cases,wrap papillary carcinoma in 1 case,1 case with ductal carcinoma in situ and infiltrating ductal carcinoma in situ with micro invasive papillary carcinoma 1 case）,mean age 52.63±10.52 years old;The benign group had 10 cases,all of which were breast fibroadenomas,with an average age of 47.5±10.1 years.The 26 cases of high quality dce-mri images were imported into omni-kinetics and GE Healthcare software for post-processing,and the quantitative parameters such as K^trans,K_epand V_ewere measured using the pharmacokinetic two-compartment model（Extengded-Tofts Linear model）.The original data of DWI image was processed with GE ADW 4.3 workstation Functool software to establish the apparent diffusion coefficient map（ADCmap）.By using two independent samples t test,compare the quantitative parameters between malignant and benign group(K^trans,K_ep,V_e,ADC values),draw the receiver-operating characteristic curve（receiver operating characteristic curve,the ROC curve）,analysis the quantitative parameter values for the differential diagnosis of benign and malignant breast tumors.The research scheme was reviewed by the hospital ethics,and all the subjects informed consent of the inspection scheme and the precautions.Results（1）.The values of K^trans,K_ep,V_eand ADC measured in breast tumors included in this study were:Malignant breast mass group（0.586±0.288）min^-1、（1.023±0.501）min^-1、（0.519±0.128）、[（1.184±0.258）×10^-3]mm²/s;Benign breast mass group（0.127±0.130）min^-1、（0.346±0.145）min^-1、（0.467±0.242）、[（1.421±0.191）×10^-3]mm²/s.（2）.The difference between K^transand K_epin Breast benign and malignant tumor was statistically significant（P<0.001）.（3）.The difference between ADC value in Breast benign and malignant tumor was statistically significant（P=0.020）.（4）.The value of V_evalue in benign and malignant breast tumors was not statistically significant（P=0.540）.（5）.The best diagnostic value is determined by the most approximate index.The sensitivity,specificity and ROC curves of K^trans,K_epand ADC values were 93.8%、87.5%、12.5%;90.0%、100.0%、40.0%and 0.978、0.909、0.769.（6）.The area under the ROC curve are 0.769（ADC）、0.988(K^transcombine ADC)、（7）0.938(K_epcombine ADC)、0.994(K^trans、K_ep、ADC together).Conclusion 1.5T MR functional imaging quantitative parameters K^trans,K_epvalue in benign and malignant tumor groups were statistically significant.The area under the ROC curve of both is greater than 0.9.It can be used as a reference index for differential diagnosis of benign and malignant breast tumors,and the diagnostic efficiency is stronger than ADC,which has important clinical application value.DCE quantitative parameters and quantitative parameters of DWI can be used to improve the benign and malignant differentiation of breast masses.