Application Of Breast MRI On Non-mass Enhancement Lesion

Objective In recent years,breast cancer had become the first of malignant tumors in women beyond the cervical cancer.Clinical palpation,X-ray mammography,ultrasound were approach to exam the breast lesions.All of them are important to diagnosis?treatment and postoperative evaluation.But it was a serious deviation of tumor size and boundary by clinical palpation.X-ray mammography was sensitive to calcification in the breast,but for dense fibroglandular tissue,it was difficult to reveal the lesion because of the low soft tissue distinguishability.Because of the low sensitivity and specificity of ultrasound,the small lesions and multiple lesions were hard to be qualitative.Breast MRI(magnetic resonance imaging,MRI)has high space and soft tissue distinguishability,high sensitivity to the lesions,and it was recognized In the clinical diagnosis and postoperative evaluation.MRI can not only to make further evaluation of breast lesions which found by the clinical,X-ray mammography and ultrasound,but also can find the recessive breast cancer that show negative by the examinations above because of its high sensitivity.In recent years with the popularity of breast MRI,Non-mass enhancement lesion was the main reason for the diagnosis of false positive rate.This study was retrospectively analyzed the MRI imaging features of Non-mass enhancement lesion in order to explore the value of the clinical and MRI feature in diagnosis,and to further articulate the BI-RADS MRI value of diagnosis and differential diagnosis in Non-mass enhancement lesion.Methods Collected 234 female patients ' s clinical and MRI material whose lesions characterized Non-mass enhancement between October 2015 and October 2016,and 240 lesions were found.All patients were confirmed by pathology.All the patients divide into benign and malignant two groups,respectively statistic analyze age,side,lesion characteristics,internal reinforcement,maximum diameter,MRI signal characteristics,TIC,DWI and ADC values,with P<0.05 was considered statistically significant,and calculated the malignant detectable rate of MRI.Calculations were performed using Stata software(version 13.0,Statacorp).Results In the Benign lesions group,126 patients were found,average age 38.67±0.89 years old,and 109 patients were found in the malignant lesions group,average age 44.47±0.89 years old.The age of onset was difference(P<0.01),the lesion characteristics,internal reinforcement,maximum diameter,TIC were also difference in statistics(P<0.01).But the side,MRI signal characteristics,DWI and ADC values had No statistical differences,and the same to ADC value in ductal carcinoma in situ and infiltrating ductal carcinoma.Analysis the malignant detectable rate of MRI,sensitivity = 92.7%,specificity = 84.6%,the missed diagnosis = 7.3%,the misdiagnosis rate = 15.4%,positive predictive value =83.6%,negative predictive value = 93.2%,the diagnostic accuracy rate = 88.3%,Youden index = 77.3%,positive likelihood ratio = 6.02.Lesions represents 54.17% in pathology,the most was mammary dysplasia 58.46%,followed was intraductal papilloma 38.46%,granulomatous mastitis 16.15%;Malignant lesions 45.83%,the most was infiltrating ductal carcinoma 50%,followed was ductal carcinoma in situ 49.09%,and 10 cases of papillary carcinoma,breast mucinous carcinoma 2 cases,invasive lobular carcinoma(3 cases),all the tumor performed Non-mass enhancementConclusion MRI performance has certain characteristics of benign and malignancy in the Non-mass enhancement lesions.MRI was high diagnosis effectiveness to Non-mass enhancement malignant lesions.Non-mass enhancement benign and malignant lesions was difference in statistics at the onset age,the lesion characteristics,internal reinforcement,maximum diameter,TIC.