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| Diagnostic value of DWI-MRI combined with mammography in breast diseases |
| TANG Xiao-wen, ZHAO Yu-nian, ZHUANG Shan, YIN Na |
| Department of Radiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China |
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Abstract Objective: To investigate the diagnostic value of DWI-MRI combined with mammography in detecting and characterizing benign and malignant breast lesions, having histological findings as the reference standard. Methods: Seventy-two patients with histologically proven breast lesions were retrospectively analyzed in this study, with all patients underwent mammography, MRI routine scan(T1 contrast enhancement, STIR, T2 weighted), and DWI. The ADC values of the lesions were measured on the ADC maps. Taking histological findings as the reference standard, the diagnostic accuracy, sensitivity and specificity of MRI examinations alone and MRI combined with X-ray mammography were calculated and compared with chi-square test or Fisher exact test. According to the pathology results, the 72 lesions were divided into benign and malignant groups, and ADCs of both groups were compared using the 2-tailed student t test or Mann-Whitney U test, with ROC analysis performed. Results: Seventy-two patients included 21 benign cases and 51 malignant ones tested by histological results. The sensitivities, specificities and accurate rates of the sole MRI examination and MRI combined with digital mammography X-ray were 91.8%, 78.3%, 88.2% and 94%, 81.8%, 92.1% respectively, through the chi-square test the latter data were higher than the former ones(χ2=15.967, P<0.05). The mean ADC value(in ×10-3 mm2/s) of the benign group(1.374±0.309) was significantly higher than that of the malignant group(0.871±0.149) (t=4.903, P<0.05), and the optimal cut-off ADC of 1.243 yielded a sensitivity of 81%, a specificity of 95.5%, and total coincidence rate of 90.2%. Conclusion: The fused application of DWI-MRI sequences ADC values in combination with X-ray mammography, can effectively improve the accuracy of diagnosis on breast lesions. It could be used as a routine application without using contrast agents in the diagnosis of breast cancer before operation, so as to decrease negative biopsy rates.
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Received: 16 August 2018
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