Li Weiyue, Hong Shaofu, Shi Yan, Zou Jinsen, Ma Jie, Gong Jingshan
Department of Radiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
Quant Imaging Med Surg. 2025 Mar 3;15(3):2457-2467. doi: 10.21037/qims-24-254. Epub 2025 Feb 26.
Due to the presence of distinctive morphological features and diverse pathological types, evaluation of breast non-mass enhancement (NME) lesions on magnetic resonance imaging (MRI) is challenging, generating more false-positive results as compared to enhancing mass lesions. Our objective was to identify the MRI features capable of distinguishing between benign and malignant NME lesions in the breast.
A retrospective analysis was conducted, in which the clinical data and MRI manifestations of 101 NME lesions were examined and confirmed through surgical or biopsy pathology. Statistical analyses, including tests, Wilcoxon rank-sum tests, χ tests, Fisher exact tests, and receiver operating characteristic (ROC) curve analyses, were employed to compare the MRI characteristics and clinical features of benign and malignant NME lesions.
The study included 101 NME lesions from 98 patients (34 benign and 67 malignant). No statistically significant differences were observed in terms of clinical characteristics between the benign and malignant groups. However, there were significant differences in lesion maximum diameter (P=0.003), morphological distribution (P=0.003), internal enhancement patterns (P<0.001), time-intensity curve (TIC) types (P<0.001), early and delayed enhancement rates (P=0.001 and P<0.001, respectively), apparent diffusion coefficient (ADC), and T2 ratio (P=0.02). Notably, the diagnostic efficacy of ADC values was highest for the minimum value within a small region of interest (small ROI), yielding an area under the curve as high as 0.884.
A comprehensive analysis of MRI features indicated their significant value for the differential diagnosis of benign and malignant NME lesions of the breast.
由于存在独特的形态学特征和多样的病理类型,乳腺磁共振成像(MRI)上非肿块强化(NME)病变的评估具有挑战性,与强化肿块病变相比会产生更多假阳性结果。我们的目的是确定能够区分乳腺良性和恶性NME病变的MRI特征。
进行回顾性分析,检查101例NME病变的临床资料和MRI表现,并通过手术或活检病理进行确诊。采用统计学分析,包括t检验、Wilcoxon秩和检验、χ²检验、Fisher确切概率法检验以及受试者工作特征(ROC)曲线分析,比较良性和恶性NME病变的MRI特征和临床特征。
该研究纳入了98例患者的101个NME病变(34个良性,67个恶性)。良性和恶性组在临床特征方面未观察到统计学显著差异。然而,病变最大直径(P = 0.003)、形态分布(P = 0.003)、内部强化模式(P < 0.001)、时间-强度曲线(TIC)类型(P < 0.001)、早期和延迟强化率(分别为P = 0.001和P < 0.001)、表观扩散系数(ADC)以及T2比值(P = 0.02)存在显著差异。值得注意的是,感兴趣小区域(小ROI)内ADC值的最小值诊断效能最高,曲线下面积高达0.884。
对MRI特征的综合分析表明其对乳腺良性和恶性NME病变的鉴别诊断具有重要价值。