Evulation The Differential Value Of Dce-mri,dwi And SWI In Breast Lesions And The Correlation Between MR Parameters With MVD,VEGF

With the rapid development of MRI, more series had began used in the research of breast lesions.The sensitivity of DCE-MRI is the highest in all series. It through morphology and haemodynamics reveal the characteristics of breast cancer. The superiority of DWI is fast and high performance, through the ADC it can describe the molecular diffusion in tumor, which can be used in differenting malignant lesions from benign lesions. The superiority of SWI is its super-sensitive with hemorrhage and deposition of iron or calcium. But it's use in breast is still in the study, have not launch in clinical. In biology aspect, the carcinogenesis, development and turnover of tumor had close relationship with MVD and VEGF.Objective: (一)Through the MR scan of DCE and DWI, evulation the lesion from morphology aspect, on the other hand, analysis all of the parameters of MR which get from image postprocessing, including: ADC,TIC,EER,Slope,SImax,Tpeak and NTV. Judgement the differential diagnosis value of every parameter. (二) To explore the correlation between MVD,VEGF and parameters of MRI . To reveal the relationship between MR parameters and angiogenesis of tumor.(三)To explore the clinical feasibility of susceptibility- weighted imaging in breast diseases.Methods: 52 patients with breast lesions received preoperative DCE-MRI,DWI and SWI scans at 3T. Record the characteristics of shape and signal, score the patients according to the MRI BI-RADS. All DCE parameters and ADC were recorded for correlation analysis. All patients were operated within 1 week after MRI.. Histopathological and immunohistochemical exams were performed on the excisions of breast lesion. Record the the expression of marginal MVD, central MVD and VEGF. (一)Compare the statistics differentce of MR parameters in benign and malignant lesions.(二)The correlations between MRI parameters and MVD, VEGF were analyzed. (三)Compare the SWI and DWI , evaluate the sensitivity of SWI . Results: (一)Based on the MRI BI-RADS: malignant group:86.4%≥4';benign group: 10% 4-5'. The shape of malignant lesion were always irregular and with inharmonious signal post-contrast.(二)The study demonstrated marginal MVD and VEGF has linear correlation with TIC, Tpeak , NTV and ADC. Strongest correlation was found between TIC and marginal MVD, as well as between Tpeak and VEGF. Central MVD has no significant correlation with all DCE parameters. Among the 52 patients, there were 22 malignant and 30 benign lesions. In comparison with benign lesions, the malignant lesions showed a washout TIC type III, higher EER, more NTV, and high expression of MVD and VEGF, but lower SImax , Tpeak and ADC(P<0.005). Slope has no significant difference between malignant and benign groups. (三)SWI has no significant specificity in breast cancer and it's sensitivity in breast diseases is only 20.3% . The sensitivity of DWI: 87.5%, ADC value has significant difference between malignant and benign groups(P<0.001).Conclusion:Among the MRI parameters,TIC,Tpeak, NTV and ADC demonstrated had correlation with MVD and VEGF, those parameters may reflecting the different angiogenesis between malignant and benign breast lesions, and therefore has most meaningful for the diagnosis for breast lesions. The sensitivity and specificity of SWI is far below than DWI in breast diseases. It's imaging has low tissue resolution, so it can not display the inner construction of tumor very good. Only in few lesions SWI can find hemorrhage,microcalcification or the compressed signs of duct., but it can't convince breast cancer independently. The clinical value of SWI in breast diseases need moor deeply research..