MRI 灌注定量分析对非肿块强化乳腺病变的诊断价值.

Objective To explore the value of dynamic contrast-enhanced (DCE)-MRI perfusion technique in distinguishing non-mass enhanced (NME) breast pathologies. Methods The clinical records and DCE-MRI of 56 women with NME breast lesions between January 2021 and December 2021 were retrospectively analyzed. Using pathological results as the reference standard, all lesions were divided into benign and malignant groups. The perfusion parameters and hemodynamic features between the two groups were compared using independent samples t-test and Mann-Whitney U test. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of MRI parameters. Results The 56 NME lesions included 33 benign and 23 malignant lesions. The early enhancement ratio (EER) was significantly higher (P<0.05) in malignancy (235.615±49.946) than that of benign lesions (181.243±69.163) whereas the late enhancement ratio (LER) was not significantly higher (P=0.247) in malignancy (197.409±35.261) than benign lesions (184.071±40.842). The DCE-MRI parameters in malignancy including the rate constant (Kep, 1.606±0.671), volume transfer constant(Ktrans, 1.380 ±0.645), initial area under the gadolinium curve (0.651 ±0.263), contrast enhancement ratio (3.026 ±0.872), maximum slope increase (MSI, 0.045) were all significantly higher ( P<0.05) than those of benign lesions (0.732 ±0.326, 0.626±0.387, 0. 356 ±0. 317, 2.270±0.498, 0.023). ROC curve analysis showed that the semi-quantitative EER had better diagnostic performance (74.4%) than that of LER (63.5%). The quantitative parameters also had better diagnostic performance than semi-quantitative parameters with accuracy of 90.3% for Kep, 84.7% for Ktrans, and 86.1% for MSI. Conclusion Quantitative perfusion parameters of DCE-MRI have excellent diagnostic performance and can help differentiating benign from malignant NME breast lesions. [ABSTRACT FROM AUTHOR]