Compare Study Between Molybdenum Target X-ray Examination And Mri On The Breast Lesions

Objective To evaluate the diagnostic effectiveness of Full Field Digital Mammography (FFDM) in patients with breast lesions; To analyze the diagnosis sensitivity and specificity of dynamic contrast-enhanced MR imaging(DEC-MRI); To analyze the statistical differences of ADC values in normal breasts, benign and malignant lesions in order to find out the differential diagnosis value of ADC values in breast lesions; To investigate the influences of b values on ADC values of normal breasts, benign lesions and malignant lesions.Materials and Methods Collecting breast mass patients found by palpation from June 2006 to January 2007,50 patients with breast masses. The patients underwent Mammography and MRI before their operation and gaining pathology, with 20-76years old. Mean 51.3 years old. Mammography and MRI examed in all patients, excluding MRI plain scan, diffusion-weighted imaging and dynamic contrast-enhancement scan.40 healthy volunteers were selected into this study and underwent MR plain scan and diffusion-weighted imaging.Mammography by Molybdenum target breast imager from GE Senographe 2000D Full Field Digital Mammography(FFDM). MRI images are taken from GE 1.5T Signa EXCITE HD superconducting MRI scanner, with 4-channal phased-array breast coil. MR examinations included about 10min 3D DCE-MRI by VIBRANT sequence with after enhanced images and DEC-MRI time-intensity curves of the lesions and DWI with b value of 600 and 1000 s/mm2 by single-shot EPI sequence. Results were correlated with histopathologic findings.Results 50 cases had 63 masses. Pathology diagnose 29 cases with 34 masses are malignant,21cases with 29 masses are benign. The diagnosis sensitivity, specificity, accuracy, positive negative predictive value of Mammography are 67.6%,69.0%,68.3%, 71.9%,64.5% respectively. The diagnosis sensitivity, specificity, accuracy, positive negative predictive value of DCE-MRI are 85.3%,89.7%,87.3%,90.6%,83.9% respectively. The difference of the accuracy between Mammography and DCE-MRI has obviously statistical significance (X2=6.612, P=0.0092<0.01).'There is statistically difference among the mean ADC value of the malignant lesions, the benign lesions and nomal breast tissues with b=600 s/mm2 or b=1000s/mm2 respectively. We select the ADC cutoff value of 1.20X 10-3 mm2/s for b=1000 s/mm2 to diagnose the benign or malignant lesions. At the cutoff values, sensitivity, specificity, accuracy and positive negative predictive value were88.2%,86.2%,87.3%,88.2%,86.2%. The difference of the accuracy between Mammography and DWI has statistical significance (X2=4.375, P=0.0395<0.05). The difference of the accuracy between DWI and DEC-MRI has no statistical significance (x 2=0.259, P=0.610>0.05).The ADC values of malignant, benign lesions and nomal breast tissues are influenced by b values whereas the degenerate breast tissuse. is not. ADC values of malignant and benign lesions are influenced significantly by b values and the lower b values are, the higher ADC values are.Conclusion The diagnosis sensitivity of Mammography is high but the specificity is low. The diagnosis sensitivity and specificity of DCE-MRI are higher than 'Mammography and have obviously statistical significance. In this study the diagnosis sensitivity and specificity of Vibrant are 85.3%å'Œ89.7% respectively and they are both higher than the documents.The diagnosis sensitivity and specificity of DWI are higher than Mammography and have statistical significance,and it is very convenient and safe. The difference of the diagnosis sensitivity and specificity between DWI and DEC-MRI has no statistical significance. So DWI can be used to help DCE-MRI to diagnose the breast lesions.