Diagnostic Value Of Magnetic Resonance Multi-parameter And Ultrasound Elastography In Breast Masses

Objective:1.To compare the differences of MRI morphological features,reinforcement mode,time-signal intensity curve（TIC）,apparent diffusion coefficient（ADC）and intravoxel incoherent motion（IVIM）of the model parameters in the benign and malignant breast masses,to investigate the diagnostic value of ADC and IVIM model parameters in identifying the benign and malignant breast masses.2.To explore the differential value of magnetic resonance imaging,ultrasonic elastic imaging and the differential diagnosis of benign and malignant breast lumps.Methods:1.Collected 109 patients with surgically removed and pathologically confirmed breast masses（121 masses）.A routine dynamic contrast enhancement of magnetic resonance imagingscan（DCE-MRI）and IVIM scanning was performed before operation,the morphological features,enhancement patterns and TIC curves of the lesions recorded DCE-MRI examined,After processing images using GE ADW 4.6workstations,D、D*、f and ADC parameters are obtained.To obtain the working characteristic curves of subjects with different parameters,evaluate the diagnostic value of each parameter.2.Ultrasound elastography（UE）was obtained for all patients（121 masses）collected UE score and Magnetic resonance imaging（MRI）Diagnostic results（BI-RADS classification）,Based on postoperative pathology,Calculation of sensitivity,specificity,positive predictive value and negative predictive value of UE、MRI alone and in combination,Draw a Receiver operating characteristic curve（ROC）for each method to diagnose a breast mass.The area under the ROC（AUC）is obtained,To analyze the diagnostic value of three diagnostic methods for breast masses.Results:1.conventional MRI results:in the malignant group,80.00%of the mass was irregular or lobulated,88.33%of the mass showed irregular margins or burrs,60.00%of the mass showed uneven enhancement,96.67%of the TIC curves of the masses showed plateau or outflow type;In the benign group,86.89%of the masses were rounded,68.85%of the masses showed smooth edges,81.89%of the masses showed homogeneous enhancement,63.93%of the lumps TIC curvilinear lesions showed inflow type.2.Between benign and malignant breast masses,ADC、D、f difference was statistically significant（P<0.001）,There was no significant difference in D*between benign and malignant breast tumors（P>0.05）.ADC、D、f values were 0.899,0.923 and 0.778 AUC the diagnosis of breast masses.According to the Jordan index,the ADC、D、f value is judged,The best cutoff values for diagnosis were respectively0.701×10^-3mm²/s、0.769×10^-3mm²/s、0.507.3.UE、MRI alone and combined diagnosis:the highest sensitivity,At 98.3%;The MRI-alone diagnosis has the highest specificity,At 93.4%;MRI alone diagnosed the highest AUC,For the term 0.934,S lightly above the two joint（0.910）,But differences are not statis significant（P>0.05）,Clearly higher above UE（0.859）,The differences are statis tically significant（P<0.05）.AUC was higher than UE alone,The differences are statis tically significant（P<0.05）.Conclusions:1.MRI morphological features,reinforcement methods and TIC curves are all different in the benign and malignant breast tumors.In the IVIM model parameters,both ADC、D and f values are more valuable in benign and malignant breast masses.2.Ultrasonic elastic imaging technology and magnetic resonance imaging technology have certain diagnostic value for the identification of benign and malignant tumors of breast masses,among which the diagnostic value has the highest value,and the two can improve the sensitivity to the differential diagnosis of benign and malignant breast tumors.