The Diagnostic Value Of Combining DCE-MRI And IVIM-DWI In Differentiating Breast Benign And Malignant Lesions

Objective: To explore the value of dynamic contrast-enhanced MRI (DCE-MRI)combined with intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of benign and malignant breast lesions.Methods: Totally 87 patients underwent DCE-MRI and IVIM-DWI were involved. 93 lesions were confirmed by pathology, of which 42 lesions were benign(benign group) and 51 were malignant (malignant group). The DCE-MRI analysis metrics included shape, enhancement characteristic, time to peak (TTP), maximum slope of increase (MSI), time signal intensity curve (TIC) pattern and compared them between the benign and malignant breast lesions. The values of f, D and D* were calculated by the software of MITK-Diffusion and compared them. Multivariate Logistic regression was adopted to identify independent factors for differential diagnosis of benign and malignant breast lesions by DCE-MRI, IVIM-DWI, combination of DCE-MRI and IVIM-DWI. Taking the results of pathological diagnosis as golden standard, ROC curve was drawn, and the area under curve (AUC) was calculated.Results: There were differences between the benign and malignant breast lesions on shape, TTP, MSI and TIC pattern (Z=-4.794, p<0.000*;Z=-3.444,p<0.001;Z=-2.123,p<0.05; Z=-6.145, p<0.000*). The values of f, D and D* were different between the benign and malignant breast lesions(t=2.214,P<0.05;t=-4.438,P<0.000* ;t=2.038,P <0.05). Shape, TIC pattern of DCE-MRI were identified as independent factors for differential diagnosis of the benign and malignant breast lesions.D value of IVIM-DWI was identified as independent factor for differential diagnosis of the benign and malignant breast lesions. On combination of the two methods, shape,TIC pattern and D value were used in multivariate logistic regression for differentiating benign and malignant breast lesions. By ROC analysis, the areas of the curve were 0.749, 0.686, 0.814 respectively; their sensitivity were 0.784,0.706,0.843;their specificity were 0.714,0.667,0.786 ;their accuracy were 0.753,0.688,0.817.Conclusion: Combination of IVIM-DWI and DCE-MRI could improve the diagnostic performance of differential diagnosis between the benign and malignant breast lesions compared to a single use.