Application value of dynamic contrast-enhanced magnetic resonance imaging in breast lesions presented as non-mass-like enhancement

doi:10.3877/cma.j.issn.1674-0807.2017.01.007

Abstract

Abstract:

Objective

To investigate the application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differential diagnosis of benign and malignant breast lesions presented as non-mass-like enhancement (NMLE).

Methods

DCE-MRI data of 70 patients with NMLE confirmed by pathology in Cangzhou People's Hospital were analyzed retrospectively from January 2012 to December 2015.The distribution characteristics, enhancement characteristics and time-intensity curve (TIC) types of NMLE lesions were analyzed by univariate analysis(χ² text and nonparametric test) and multivariate Logistic regression analysis, and apparent diffusion coefficient (ADC) was compared by t test to explore the difference between benign and malignant lesions.

Results

In 70 patients with NMLE, 28 patients had benign lesions and 42 patients had malignant lesions. The ADC value was (1.36 ± 0.27) ×10^-3 mm²/s in benign lesions and(1.09 ± 0.22) ×10^-3 mm²/s in malignant lesions, indicating a significant difference (t=4.644, P＜0.001).Univariate analysis showed that malignancy of NMLE lesions was related to distribution characteristics and enhancement characteristics (χ²=11.013,P=0.009;χ²=8.163,P=0.041). Multivariate Logistic regression analysis showed that segmental distribution was an independent risk factor for malignant lesions (OR=7.543,95%CI:1.963-28.981, P=0.003).

Conclusions

DCE-MRI has a high application value in differential diagnosis of benign and malignant lesions of NMLE. Segmental distribution often indicates malignant lesions.

Key words: Magnetic resonance imaging, Diagnosis, differential, Carcinoma, ductal, breast

Zengkui Wang, Dongliang Yang, Chunjie Wang, Wenjing Sun. Application value of dynamic contrast-enhanced magnetic resonance imaging in breast lesions presented as non-mass-like enhancement[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(01): 33-38.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhrxbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0807.2017.01.007

https://zhrxbzz.cma-cmc.com.cn/EN/Y2017/V11/I01/33

Figures/Tables 8

References 17

[1]	American College of Radiology. Breast imaging reporting and data system [M]. 4th ed. Reston: American College of Radiology, 2003:1-114.
[2]	Edwards SD,Lipson JA,Ikeda DM,et al. Updates and revisions to the BI-RADS magnetic resonance imaging lexicon[J].Magn Reson Imaging Clin N Am,2013,21(3):483-493.
[3]	李晓,程流泉,刘梅,等. MRI、钼靶和超声对乳腺非肿块样强化病变诊断的对比研究[J]. 中国医学影像学杂志,2013,21(5):336-340.
[4]	Heller SL, Moy L, Lavianlivi S, et al. Differentiation of malignant and benign breast lesions using magnetization transfer imaging and dynamic contrast-enhanced MRI[J]. J Magn Reson Imaging, 2013,37(1):138-145.
[5]	Shao Z, Wang H, Li X, et al. Morphological distribution and internal enhancement architecture of contrast-enhanced magnetic resonance imaging in the diagnosis of non-mass-like breast lesions: a metaanalysis [J]. Breast J,2013,19(3):259-268.
[6]	Yabuuchi H, Matsuo Y, Kamitani T, et al. Non-mass-like enhancement on contrast-enhanced breast MR imaging: lesion characterization using combination of dynamic contrast-enhanced and diffusion-weighted MR images[J]. Eur J Radiol, 2010, 75(1):e126-132.
[7]	张静,蔡幼铨.乳腺MR 影像报告和数据系统(BI-RADS-MRI)的临床应用[J]. 中国医学影像学杂志,2009,17(1):51-53.
[8]	Imamura T, Isomoto I, Sueyoshi E, et al. Diagnostic performance of ADC for non-mass-like breast lesions on MR imaging[J]. Magn Reson Med Sci,2010,9(4):217-225.
[9]	Liu H, Peng W. MRI morphological classification of ductal carcinoma in situ(DCIS)correlating with different biological behavior[J]. Eur J Radiol,2012,81(2):214-217.
[10]	王丽君, 汪登斌, 李志, 等. 特发性肉芽肿性小叶乳腺炎的影像特点与鉴别诊断[J].国际医学放射学杂志,2014,37(1):18-21.
[11]	Newell D, Nie K, Chen JH, et al. Selection of diagnostic features on breast MRI to differentiate between malignant and benign lesions using computer-aided diagnosis: differences in lesions presenting as mass and non-mass-like enhancement[J]. Eur Radiol,2010,20(4):771-781.
[12]	Thomassin-Naggara I, Salem C, Darai E, et al. Non-masslike enhancement on breast MRI: interpretation pearls [J]. J Radiol,2009,90(3 Pt 1):269-275.
[13]	Aslan H, Pourbagher A, Colakoglu T. Idiopathic granulomatous mastitis: magnetic resonance imaging findings with diffusion MRI [J].Acta Radiol,2016,57(7):796-801.
[14]	王丽君,汪登斌,费晓春,等. 非哺乳期乳腺炎性病变的MRI 表现及其与病理的对照研究[J]. 中华放射学杂志,2014,48(10):836-840.
[15]	Jansen SA, Fan X, Karczmar GS, et al. DCEMRI of breast lesions: is kinetic analysis equally effective for both mass and nonmass-like enhancement? [J]. Med Phys,2008,35(7):3102-3109.
[16]	Spick C, Bickel H, Pinker K, et al. Diffusion-weighted MRI of breast lesions: a prospective clinical investigation of the quantitative imaging biomarker characteristics of reproducibility, repeatability, and diagnostic accuracy[J]. NMR Biomed,2016,29(10):1445-1453.
[17]	Cheng L, Bai Y, Zhang J, et al. Optimization of apparent diffusion coefficient measured by diffusion-weighted MRI for diagnosis of breast lesions presenting as mass and non-mass-like enhancement[J]. Tumour Biol,2013,34 (3):1537-1545.

变量	赋值
分布特点	将弥漫性分布作为参照组,将局限性区域分布、节段性分布、导管样分布作为哑变量
强化方式	将集簇状强化作为参照组,将均匀强化、不均匀强化、簇状环形强化作为哑变量
时间-信号强度曲线类型	Ⅰ型=1,Ⅱ型=2,Ⅲ型=3
良恶性	恶性=1,良性=0

变量	赋值
分布特点	将弥漫性分布作为参照组,将局限性区域分布、节段性分布、导管样分布作为哑变量
强化方式	将集簇状强化作为参照组,将均匀强化、不均匀强化、簇状环形强化作为哑变量
时间-信号强度曲线类型	Ⅰ型=1,Ⅱ型=2,Ⅲ型=3
良恶性	恶性=1,良性=0

病理学类型	例数
良性
腺病	10
囊性增生	5
乳腺炎症及脓肿	9
导管内乳头状瘤	4
恶性
浸润性导管癌	17
浸润性小叶癌	9
导管原位癌	13
导管内乳头状癌	2
Paget病	1

病理学类型	例数
良性
腺病	10
囊性增生	5
乳腺炎症及脓肿	9
导管内乳头状瘤	4
恶性
浸润性导管癌	17
浸润性小叶癌	9
导管原位癌	13
导管内乳头状癌	2
Paget病	1

变量	良性组(n=28)	恶性组(n=42)	检验值	P值
分布特点
局限性区域	9	8	χ²=11.013	0.009
节段性	5	22
导管样	2	5
弥漫性	12	7
强化方式
均匀强化	6	2	χ²=8.163	0.041
不均匀强化	11	15
簇状环形强化	4	17
集簇状强化	7	8
TIC类型
Ⅰ型	7	11	Z=-0.476^a	0.634
Ⅱ型	13	22
Ⅲ型	8	9

Please choose a citation manager

Content to export