Diagnostic Value Study Of 3.0T DCE-MRI Combined With MB-DWI In Benign And Malignant Breast Nodules Of Young Women

Objective: According to statistics,around the world,about 1 million 200 thousand women suffering from breast cancer each year,500 thousand people died of breast cancer,which mortality rate is second only to lung cancer.In China,breast cancer has become one of the most serious diseases that threatening women's health.The incidence of breast cancer has increased significantly,and there is a trend of younger.Therefore,early detection,diagnosis and treatment of breast cancer is of great significance to the prognosis of patients.This study of young women with breast nodular lesions underwent conventional MRI,DCE-MRI and DWI combined with multi b value,aims to improve the diagnosis efficiency of young female breast nodular lesions.Materials and methods:Collected 83 cases of breast nodular lesions in young women(?40 years old)from February 2016 to February 2017 in our hospital.All cases were examined by MRI in our hospital.Among them,46 cases were diagnosed by ultrasound puncture biopsy or postoperative pathology.benign lesions in 29 cases,malignant lesions in 17 cases.All cases were young women(?40 years old)with a minimum age of 17 years and a maximum age of 40 years,with an average age of 31.2 years.29 cases of benign lesions,19 cases of fibroadenoma,5 cases of fibrocystic disease of breast,3 cases of breast adenosis,2 cases of intraductal papilloma.17 cases of malignant lesions,non-specific invasive carcinoma in 9 cases,intraductalcarcinoma 4 cases,lobular carcinoma in situ in 3 cases,carcinome Paget du sein in 1 cases.There were 6 cases with axillary lymph node metastasis.All cases of MRI were performed within 1 weeks before surgery,using GE 3.0T high field magnetic resonance scanner,breast dedicated 8 channel phased array surface coil.In order for T1 WI,fs-T2 WI,DWI and DCE-MRI.All images were processed and measured in the GE 3.0 workstation,were recorded in morphology,lesion enhancement(Early Enhancement Rate),time signal intensity curve(TIC),and apparent diffusion coefficient(ADC),including the maximum value and the minimum value of ADC and an average of ADC value.Use SPSS20.0 statistical analysis software to analyze and process the data.The mean of the measurement data between groups was compared by t test.The comparison of the count data using chi square test,the difference was statistically significant with P<0.05.According to the pathological results,the sensitivity,specificity and accuracy of each imaging observation index were calculated,and the diagnostic performance of each parameter was judged according to the receiver characteristic curve(ROC).Results:1.morphological characteristics and enhancement pattern :The morphology and enhancement of benign nodules were mainly manifested as :the boundary is clear,leaves are rare,homogeneous enhancement,and edge enhancement or weak enhancement and no enhancement;malignant nodules enhanced mainly manifested as: inhomogeneous enhancement,early enhancement or enhanced like cicatricial or cluster,and the spicule sign has significance of differential diagnosis.Benign lesions SER was significantlylower than that of malignant lesions,the difference was statistically significant(P < 0.05).2.TIC curve types: benign nodules in TIC curve type I(inflow type)accounted for(24/29),II(platform type)accounted for 4(4/29),type III(outflow type)accounted for 1(1/29);malignant nodules type I(inflow type)accounted for 1(1/17),II(platform type)accounted for 2(2/17),type III(outflow type)accounted for 14(14/17).3.DWI and ADC values: the most ADC value of benign and malignant nodules,the minimum ADC value and the average ADC value between the groups were statistically significant(P<0.05).The average ADC value is the best.4.the selection of b value: record b= 200 s/mm2,400s/mm2,600 s/mm2,800 s/mm2 and 1000s/mm2 respectively,the average ADC value of benign nodules were 1.48±0.29×10-3mm2/s ? 1.60±0.32×10-3mm2/s ? 1.73±0.25×10-3mm2/s?1.7±0.22×10-3mm2/s?1.85±0.22×10-3mm2/s.The average ADC value of malignant nodules were 1.43±0.33×10-3mm2/s ?1.25±0.33×10-3mm2/s ? 1.05±0.23×10-3mm2/s ? 0.89±0.16×10-3mm2/s ?0.87±0.26×10-3mm2/s.There was statistical significance between benign and malignant nodules.Among them,when the b=800s/mm2,it has best diagnostic performance(P<0.01).Conclusion:1.the morphology of benign and malignant breast nodules and enhancement pattern has certain characteristics: malignant nodules edge burr syndrome has statistical significance;benign nodules early enhancement rate was significantly lower than that of malignant nodules and benign nodules early enhancement rate;TIC curve with I(inflow type);malignant nodulesTIC curves with III(out)mainly,with statistical significance between the two(P<0.05).2.Magnetic resonance multi b DWI imaging is valuable for the diagnosis of benign and malignant breast nodules in young women:3.The selection of ADC value is of great significance in the diagnosis of benign and malignant breast nodules: the diagnostic efficacy of ADCacg is the best.4.the b value of the diagnosis of benign and malignant breast nodules is of great significance: when b=800s/mm2,when the ROC curve of the largest AUC,the best diagnostic efficiency.