Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.
AJR Am J Roentgenol. 2011 Jan;196(1):210-7. doi: 10.2214/AJR.10.4258.
The purpose of our study was to evaluate the diagnostic value of an imaging protocol that combines dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with suspicious breast lesions and to determine if additional information provided by DWI improves the diagnostic value of breast MRI.
Eighty-four patients with breast tumors (37 benign, 47 malignant) underwent DCE-MRI and DWI before biopsy. Morphologic and kinetic analyses were performed on DCE-MRI and findings were classified according to the BI-RADS lexicon. Apparent diffusion coefficient (ADC) values were calculated from the DWI. The ADCs of the benign and malignant lesions were compared. For the combined MRI protocol, morphologic kinetic features and ADCs were evaluated together. Diagnostic values of DCE-MRI, DWI, and combined MRI were calculated.
Median ADCs of the benign and malignant lesions were 1.26 × 10(-3) mm(2)/s and 0.75 × 10(-3) mm(2)/s, respectively. Cutoff value of 0.92 × 10(-3) mm(2)/s for ADC provided 91.5% sensitivity and 86.5% specificity. DCE-MRI alone showed 97.9% sensitivity and 75.7% specificity. The combination of DCE-MRI with DWI provided 95.7% sensitivity and 89.2% specificity. The specificity of breast MRI improved by 13.5% (p = 0.063) without a significant decrease in the sensitivity (p = 1.000).
The combination of DWI and DCE-MRI has the potential to increase the specificity of breast MRI.
本研究旨在评估联合动态对比增强磁共振成像（DCE-MRI）和弥散加权成像（DWI）的影像学方案在疑似乳腺病变患者中的诊断价值，并确定 DWI 提供的额外信息是否能提高乳腺 MRI 的诊断价值。
84 例乳腺肿瘤患者（37 例良性，47 例恶性）在活检前行 DCE-MRI 和 DWI。对 DCE-MRI 进行形态学和动力学分析，并根据 BI-RADS 词汇表进行分类。从 DWI 计算表观扩散系数（ADC）值。比较良性和恶性病变的 ADC 值。对于联合 MRI 方案，同时评估形态动力学特征和 ADC 值。计算 DCE-MRI、DWI 和联合 MRI 的诊断价值。
良性和恶性病变的中位数 ADC 值分别为 1.26×10(-3)mm(2)/s 和 0.75×10(-3)mm(2)/s。ADC 的截断值为 0.92×10(-3)mm(2)/s，其灵敏度为 91.5%，特异性为 86.5%。单独的 DCE-MRI 显示出 97.9%的灵敏度和 75.7%的特异性。DCE-MRI 联合 DWI 提供了 95.7%的灵敏度和 89.2%的特异性。乳腺 MRI 的特异性提高了 13.5%（p=0.063），而灵敏度没有显著下降（p=1.000）。
DWI 和 DCE-MRI 的联合应用有可能提高乳腺 MRI 的特异性。
