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Objective:To explore the clinical application value of dynamic contrast-enhanced MRI (DCE) time-signal intensity curve (TIC) combined with diffusion weighted imaging (DWI) in the diagnosis of benign and malignant breast lesions.Methods:This study was a retrospective study. 95 patients with suspected breast cancer who were diagnosed and treated in the Beijing Huairou Hospital from October 2018 to October 2021 were taken as the study subjects. All patients received DCE-TIC and DCE-DWI examinations, and then underwent needle biopsy after imaging examination. We evaluated the diagnostic efficacy of DCE-TIC and DCE-DWI alone and in combination in benign and malignant breast lesions by collecting general clinical data and apparent diffusion coefficient (ADC) values of patients, using pathological examination results as the " gold standard" .Results:A total of 95 patients with suspected breast cancer were diagnosed as benign lesions in 25 cases and malignant lesions in 70 cases after biopsy. Compared with benign lesions, the tumor diameter and ADC value of malignant lesions were significantly different (all P<0.05). The eceiver operating characteristic (ROC) curve of subjects was drawn, and the area under the curve (AUC) of DCE-DWI diagnosis of breast cancer was 0.826. 95 suspected breast cancer patients were diagnosed by DCE-TIC in 28 cases of type Ⅰ, 27 cases of type Ⅱ, and 40 cases of type Ⅲ. With the pathological diagnosis results as the " gold standard", the accuracy, sensitivity, and negative predictive value of DCE-TIC combined with DCE-DWI in the diagnosis of breast cancer were higher than those of a single diagnosis, with a statistically significant difference (all P<0.05); The specificity and positive predictive value of combined diagnosis were not statistically significant compared to single diagnosis (all P>0.05). Conclusions:Both DCE-TIC and DCE-DWI can differentiate benign and malignant breast lesions, and the accuracy, sensitivity, and positive predictive value of combined diagnosis are higher than those of single diagnosis. The combination of DCE-TIC and DCE-DWI can help improve the differential efficiency of breast lesion properties.
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Objective@#To study the application of intravoxel incoherent motion (IVIM) quantitative index combined with time-signal intensity curve (TIC) of dynamic contrast enhanced 3.0T magnetic resonance in the early precise diagnosis of residual lesions in non-small cell lung cancer (NSCLC) after argon-helium cryosurgery.@*Methods@#One hundred NSCLC patients who underwent argon-helium cryosurgery were collected and divided into the residual group (21 cases) and non-residual group (79 cases) according to the result of needle biopsy and follow-up. The apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (sADC), fast apparent diffusion coefficient (fADC), fraction of fast apparent diffusion coefficient (ffADC) and TIC type of IVIM quantitative index between the two groups were compared at 7 days and 1 month after argon-helium cryosurgery, respectively. The diagnosis performance of each quantitative index was analyzed by receiver operating characteristic (ROC) curve and the best cut-off value was computed. The specificity and sensitivity of TIC types were calculated as diagnostic criteria. The diagnosis performance of IVIM quantitative index combined with TIC type was evaluated and compared with the conventional MRI and DWI.@*Results@#The differences of ADC, sADC and ffADC at 7 days and 1 month after argon-helium cryosurgery between the residual group and non-residual group were statistically significant (all P<0.05), in which the diagnosis performance of sADC and ffADC were better. The AUC of sADC and ffADC at 7 days after argon-helium cryosurgery were 0.861 and 0.895, the sensitivity were 81.0% and 90.5%, and the specificity were 77.2% and 73.4%, respectively. The AUC of sADC and ffADC at 1 month after argon-helium cryosurgery were 0.836 and 0.883, the sensitivity were 100.0% and 76.2%, and the specificity were 58.2% and 89.9%, respectively. The diagnosis performance of TIC type Ⅱ&Ⅲ was best. The sensitivity and specificity were 80.9% and 58.2% at 7 days after treatment, 85.7% and 62.0% at 1 month after treatment, respectively. At 7 days after treatment, the sensitivity and specificity of IVIM combined with TIC were 97.5% and 85.7%, while at 1 month after treatment, the sensitivity and specificity of IVIM combined with TIC were 97.5% and 90.5%, respectively. The diagnosis performance of IVIM quantitative index combined with TIC type was better than conventional MRI and DWI.@*Conclusion@#The combination of IVIM quantitative index and TIC type can be used in the early diagnosis of residual lesions after argon-helium cryosurgery for NSCLC, whose effect is better than conventional MRI and DWI.
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Objective Differentiation of breast fibroadenoma from breast cancer is of great importance. The purpose of the ar-ticle was to evaluate the diagnostic efficacy of magnetic resonance imaging(MRI) in the differentiation of breast fibroadenoma from breast cancer in DCE-TIC ( dynamic contrast enchancement-time intensity curve) platform type ( typeⅡ) . Methods Between March 2014 and May 2016, 64 patients were included in our study, 19 patients with breast fibroadenoma and 45 patients with breast cancer. All the patients underwent DCE-MRI ( dynamic contrast-enhanced magnetic resonance imaging) examination before operation. Morpho-logic characteristics, hemodynamic characteristics, EER ( early enhancement rate) and ADC ( apparent diffusion coefficient) values were calculated and statistically compared. Results Among 19 cases of breast fibroadenoma, 9 cases were round or ovoid, 8 cases are lobulated, 2 cases were irregular, 15 cases with clear boundary, 14 cases in mammary gland vascular enlargement, 2 cases of slowinflows, 4 cases of moderate inflows, 13 cases of rapid inflows, and the average ADC value was ( 1. 47 ± 0. 38) × 10-3 mm2/s. Low signal separation present in 11 lesions of fibroadenoma. Among the 45 cases of breast cancer, 17 cases were round or ovoid, 7 cases were lobulat-ed, 21 cases were irregular, 11 cases with clear boundary, 38 cases of mammary gland vascular enlargement, 1 case of slow inflows, 5 ca-ses of moderate inflows, 39 cases of rapid inflows, and the averageADC values was (0.98±0.40)×10-3mm2/s. The shape, (χ2=9.176), margin (χ2=16.452), EER(χ2=18.489) and ADC between breast fibroadenoma and breast cancer were of significantly difference. No significant difference was found in the increased and enlarged blood vessels. The success of ADC values in differentation of breast fibroadenoma from breast cancer was statistically significant( P<0.001), and the area under the curve(AUC)of the ROC, sensitivity and specificity of VE were 94.7% and 71.1%. Conclusion Breast fibroadenoma are in fast inflows in the early phase on the DCE-MRI, and there are differences in morphologic characteristics and mass enhancement ways between patients with breast fibroadenoma and breast cancer. Morphologic characteristics combined with inter-nal low signal separation contribute to the differentiation of breast fibroadenoma from breast cancer.
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Objective To investigate the MRI findings of the breast fibroadenoma which has a washout type of time signal intensity curve (TIC)for the purpose of improving imaging diagnosis.Methods The MRI findings of 20 cases of the breast fibroadenoma with a washout TIC and 20 cases of breast carcinoma verified by histopathology were analyzed retrospectively.Morphological features,internal signal, ADC value and dynamic enhancement performance of the two groups were compared with each other.Results The shapes of the breast fibroadenomas were more commonly ovoid or round (18/20),and the margins were circumscribed(16/20),Most of the fibroadenomas were high intensity in T2 WI with the non-contrast enhanced separations (9/20).The average minimum ADC value was (1.412±0.332)×10-3 mm2/s,and higher than that of breast cancer (0.888 ±0.1 60)×10 -3 mm2/s with the significant difference (P 0.05 ). Conclusion The breast fibroadenoma with washout TIC has a similar performance with the breast cancer in TIC and the early enhancement rate, however,the clear edge,higher T2 WI signal intensity,the non-contrast enhanced internal separations and higher ADC values are helpful to the diagnosis of breast fibroadenoma with washout TIC.
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OBJECTIVE: We aimed to evaluate the use of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) at 3.0 T for differentiating the benign from malignant soft tissue tumors. Also we aimed to assess whether the shorter length of DCE-MRI protocols are adequate, and to evaluate the effect of temporal resolution. MATERIALS AND METHODS: Dynamic contrast-enhanced magnetic resonance imaging, at 3.0 T with a 1 second temporal resolution in 13 patients with pathologically confirmed soft tissue tumors, was analyzed. Visual assessment of time-signal curves, subtraction images, maximal relative enhancement at the first (maximal peak enhancement [Emax]/1) and second (Emax/2) minutes, Emax, steepest slope calculated by using various time intervals (5, 30, 60 seconds), and the start of dynamic enhancement were analyzed. RESULTS: The 13 tumors were comprised of seven benign and six malignant soft tissue neoplasms. Washout on time-signal curves was seen on three (50%) malignant tumors and one (14%) benign one. The most discriminating DCE-MRI parameter was the steepest slope calculated, by using at 5-second intervals, followed by Emax/1 and Emax/2. All of the steepest slope values occurred within 2 minutes of the dynamic study. Start of dynamic enhancement did not show a significant difference, but no malignant tumor rendered a value greater than 14 seconds. CONCLUSION: The steepest slope and early relative enhancement have the potential for differentiating benign from malignant soft tissue tumors. Short-length rather than long-length DCE-MRI protocol may be adequate for our purpose. The steepest slope parameters require a short temporal resolution, while maximal peak enhancement parameter may be more optimal for a longer temporal resolution.