Enhanced Mass on Contrast-Enhanced Breast MR Imaging: Lesion Characterization Using Combination of Dynamic Contrast-Enhanced and Diffusion-Weighted MR Images
Enhanced Mass on Contrast-Enhanced Breast MR Imaging: Lesion Characterization Using Combination of Dynamic Contrast-Enhanced and Diffusion-Weighted MR Images
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DOI：
10.1002/jmri.21570
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发表时间：
2008-11-01
影响因子：
4.4
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
--
作者：
Yabuuchi, Hidetake;Matsuo, Yoshio;Honda, Hiroshi
目的：评价动态增强磁共振成像(DCE-MRI)和弥散加权磁共振成像(DWI)联合应用对乳腺强化肿块的诊断价值，寻找乳腺良性肿瘤与癌的最佳鉴别指标。材料与方法：分析270例乳腺MRI连续图像，排除93例13个病变。我们分析了肿瘤的大小、形态、边缘、内部肿块强化、动力学曲线模式和表观扩散系数(ADC)值。我们应用单变量和多变量分析来寻找恶性程度最强的指标，并计算恶性程度的预测概率。我们将相应的类别添加到这些恶性肿瘤的预测概率中，并计算了当我们认为4b、4c和5类病变为恶性和4a类病变时的诊断准确性。3.良性病变2例。结果：边缘不规则、内部不均匀强化、边缘强化、平台型和冲洗型是最强的恶性指标，ADC值<1.1×10~(-3)mm(2)/S也是最强的恶性指标。在验证性研究中，敏感度、特异度、阳性预测值、阴性预测值和准确性分别为92%(56/61)、86%(12/14)、97%(56/58)、71%(12/17)和91%(68/75)。
Purpose: To evaluate the diagnostic accuracy of a combination of dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted MR imaging (DWI) in characterization of enhanced mass on breast MR imaging and to find the strongest discriminators between carcinoma and benignancy.Materials and Methods: We analyzed consecutive breast MR images in 270 patients; however, 13 lesions in 93 patients were excluded based on our criteria. We analyzed tumor size, shape, margin, internal mass enhancement, kinetic curve pattern, and apparent diffusion coefficient (ADC) values. We applied univariate and multivariate analyses to find the strongest indicators of malignancy and calculate a predictive probability for malignancy. We added the corresponding categories to these prediction probabilities for malignancy and calculated diagnostic accuracy when we consider category 4b, 4c, and 5 lesions as malignant and category 4a. 3. and 2 lesions as benign. In a validation study, 75 enhancing lesions In 71 patients were examined consecutively.Results: Irregular margin, heterogeneous internal enhancement, rim enhancement, plateau time-intensity curve (TIC) pattern, and washout TIC pattern were the strongest indicators of malignancy as well as past studies, and ADC values less than 1.1 X 10(-3) mm(2)/S were also the strongest indicators of malignancy. In a validation study, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 92% (56/61), 86% (12/14), 97% (56/58), 71% (12/17), and 91% (68/75), respectively.Conclusion: The combination of DWI and DCE-MRI could produce high diagnostic accuracy in the characterization of enhanced mass on breast MR Imaging.