Clinical value of synthetic MRI and dynamic contrast-enhanced MRI in the differentiation of benign and malignant breast lesions / 中华放射学杂志

ABSTRACT

Objective:To explore the value of synthetic MRI and dynamic contrast-enhanced MRI (DCE-MRI) in differentiating benign and malignant breast lesions.Methods:Totally 116 patients (female, aged 22-80 years) with suspicious breast lesions found by clinical examination in General Hospital of Ningxia Medical University from September 2020 to March 2021 were retrospectively analyzed. All patients received synthetic MRI and DCE-MRI scans, and the quantitative parameters of synthetic MRI [T 1, T 2, proton density (PD) value before enhancement of breast lesions (T 1pre, T 2pre, PD pre) and T 1, T 2, PD value after enhancement of breast lesions (T 1Gd, T 2Gd, PD Gd)] were measured. The difference before and after enhancement (?T 1, ?T 2, ?PD) and the ratio before and after enhancement(T 1ratio, T 2ratio, PD ratio) were calculated. All lesions were confirmed by biopsy or surgery. Independent sample t test was used to compare the differences of parameters between benign and malignant lesions, and parameters with statistically significant differences were analyzed by multivariate logistic regression to screen out independent predictors for the diagnosis of breast malignant lesions. The efficacy of quantitative parameters alone and in combination with DCE-MRI, was evaluated by the receiver operating characteristic (ROC) curve. Results:Of 116 patients, 27 patients were benign and 89 patients were malignant. T 2pre, PD pre, T 2Gd, PD Gd, ?T 2, T 1ratio and T 2ratio values of malignant patients were lower than those of benign lesions ( P<0.05). Multivariate logistic regression analysis showed that T 2pre (OR=0.961,95%CI 0.926-0.993, P=0.022)and PD pre(OR=0.945, 95%CI 0.908-0.979, P=0.003) were independent predictors of breast malignant lesions. The area under ROC curve (AUC) of T 2pre+PD pre in differentiating benign and malignant breast lesions was 0.77, and the accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 0.84, 0.87, 0.68, 0.92 and 0.56, respectively. The AUC of T 2pre+PD pre combined with DCE-MRI in differentiating benign and malignant breast lesions was 0.95, indicating the best diagnostic efficiency, and higher than that of DCE-MRI alone (0.92)( Z=2.20, P<0.05). Conclusions:T 2pre and PD pre values of synthetic MRI can be used as reference parameters for differentiating benign and malignant breast lesions. Synthetic MRI combined with DCE-MRI can effectively improve the diagnostic efficiency of breast malignant lesions.