| Objective: To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in differentiating benign breast inflammatory lesions.Materials and Methods: This retrospective study was approved by the institutional review board and requirement for informed consent was waived. 61 breast benign inflammatory lesions of 61 female patients who underwent preoperative breast imagings both DCE-MRI and DWI(b=800 s/mm2) were reviewed. According to the pathologic results, three groups were Nonspecific Mastitis(NM group, 32 patients, mean age, 41.34 ± 12.71 year), Abscess(AB group, 12 patients, mean age, 41.33 ± 18.79 year) and Granulomatous Mastitis(GM group, 17 patients, mean age, 44.47 ± 14.68year). The morphologic characteristics, types of TIC curves of the lesions and ADC values were recorded. Intraclass correlation coefficient(ICC) was used to test the consistency of the different ADC values.One-way ANOVA test was applied to compare ADC values of the three groups.SNK test was used to compare between two groups. Logistic analysis was applied to analyze the general data of three groups. Discriminative abilities of models were compared by using the area under the receiver operating characteristic curve(AUC).Results1. The ICC value of consistency of the two measurement of ADC values for three groups were 0.829, 0.794 and 0.844, the total is 0.853.2. There was significant difference of the ADC value among three groups(P<0.05). For NM and AB, NM and GM, AB and GM groups, the AUC of ADC values were 0.794, 0.733 and 0.647 between two different groups respectively, the sensitivity was 0.813, 0.844and0.706 respectively, the specificity was 0.833, 0.647 and 0.667 respectively.The reliable range of ADC values in diagnosing different kinds of breast inflammatory lesions: NM> 1.348 × 10-3 mm2/s, AB < 1.125 × 10-3 mm2/s, 1.125 ×10-3 mm2/s < GM< 1.328 × 10-3 mm2/s.3. There was significant difference about types of TIC cure among three groups(P<0.05). Of NM group, 69% cases were type I, and 31% were type II; Of AB group,33% cases were type I, 42% cases were type II and 25% were type III; Of GM group,the most cases were type II(64%). For NM and AB, NM and GM, AB and GM groups, the AUC of TIC type were 0.716, 0.783 and 0.534 between two different groups respectively.4. DCE-MRI combining with DWI, the diagnostic sensitivity and specificity were both higher between NM, AB and NM, GM, while lower between AM and GM.The discriminative ability of ADC value in diagnosing three types was higher than TIC type.5. There was no significant difference of mass and nonmass enhancement or mass lesion enhancement characteristics among three groups, while there was significant difference in distribution of nonmass enhancement among three groups.6. Between the NM group, AB group, GM group general data analysis, different types of inflammatory breast disease and breast, one side breast, patient age had no correlation; At the same time DWI and T2 WI signal can no statistical difference.Conclusions1. ADC value was the most efficient indicator in differentiating breast inflammatory lesions.2. The blood supply of the benign inflammatory lesions can be reflected by types of TIC curve.There was significantly difference of morphological features especially with nonmass enhancement distribution in differentiating inflammatory breast diseases.3. It was accuracy for diagnosing different benign inflammatory breast diseases combining DCE-MRI with DWI characteristics. |
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