RESUMEN
To determine the diagnostic contribution of diffusion weighted imaging [DWI] and magnetic resonance spectroscopy [MRS] identified either with mammography, ultrasonography or conventional enhanced magnetic resonance imaging [MRI] to cases with palpable breast lesions or for routine control. Prospective study. Department of Radiology, Celal Bayar University, Turkey. Fifty female patients who applied to the clinic between November 2009 and April 2010 with different indications were included. We applied conventional breast MRI with the routine sequences. We added DWI and BREASE [MRS]. After MRI examination postprocessing applications were applied. Analysis of contribution of advanced techniques in breast lesions diagnosis. Determining the value of DWI and MRS of breast lesions, which may be useful in improving the specificity. Fifty-two breast lesions in 37 cases were evaluated. In DWI when cut off apparent coefficient diffusion [ACD] value was accepted as 1.44 xlO.3 mm[2]/sn, the sensitivity was found to be 91.3% and the specifity was 62.1% in discriminating malignant and benign lesions. When the lesions which have choline peak at 3.2 ppm were accepted as malignant and lesions which do not have choline peak were accepted as benign lesions in spectroscopic examination, the specifity was 80%, the sensitivity was 31.8%, negative predictive value [NPV] was 44.4% and positive predictive value [PPV] was found to be 70%. Our specifity was compatible with that in the literature but sensitivity and negative ppv were lower than reported in the literature. According to ADC values, the findings in our study were compatible with the literature
RESUMEN
<p><b>INTRODUCTION</b>The specificity of conventional magnetic resonance (MR) imaging is lower than its high sensitivity. Diffusion-weighted imaging (DWI), based on alterations in the microscopic motion of water molecules, promises improved specificity for breast MR imaging. In this study, we aimed to determine the diagnostic potential of DWI to differentiate between benign and malignant breast lesions and normal breast tissue.</p><p><b>METHODS</b>Dynamic contrast-enhanced breast MR imaging and DWI were applied to 108 women. Apparent diffusion coefficient (ADC) values were obtained for normal breast tissue (n = 183), benign lesions (n = 66) and malignant lesions (n = 58). The results were compared with the patients' final diagnoses.</p><p><b>RESULTS</b>Mean ADC values for benign and malignant breast lesions were 1.04 × 10-3 ± 0.29 × 10-3 mm2/s and 2.00 × 10-3 ± 0.55 × 10-3 mm2/s, respectively (p = 0.001, Student's t-test), while that for normal breast tissue was 1.78 × 10-3 ± 0.33 × 10-3 mm2/s. With a cut-off value of 1.46 × 10-3 mm2/s for ADC in receiver operating characteristic analysis, 95% sensitivity and 85% specificity were achieved for differentiating between benign and malignant lesions.</p><p><b>CONCLUSION</b>DWI of the breast can help differentiate benign and malignant breast lesions from normal breast tissue. DWI, which can be easily introduced into standard breast MR imaging protocols without increasing imaging times, promises to increase the accuracy of breast MR imaging without contrast media. However, its clinical value will depend on the standardisation of b-values and other technical parameters in larger future study series.</p>