3.0 T MR diffusion tentor imaging in the differential diagnosis of breast mass lesions

Objective To investigate the differential diagnostic value of DTI parameters in breast mass lesions by comparing apparent diffusion coefficient (ADC), fractional aniotropy (FA) and maximum eigenvalue (λ1)of normal glandular tissue, benign lesions and malignant lesions. Methods A total of 71 women patients with 74 mass lesions between December 2013 and October 2015 were enrolled from Beijing Chao-Yang Hospital.MRI protocol included dynamic contrast-enhanced MRI (DCE-MRI)and diffusion tentor imaging(DTI) were executed.The ADC, λ1 and FA of lesions and normal glandular tissue were calculated.The ADC, λ1 and FA of lesions were compared by paired t test between the benign/malignant tumors and the contratlateral healthy breast tissue.ROC curve analysis was performed to compare diagnostic performance based on the area under the curve(AUC). The sensitivity and specificity of the DCE-MRI combined with ADC and DCE-MRI combined with λ1 were calculated. Results The ADC, FA and λ1 values of malignant lesions were (1.09±0.18)×10-3 mm2/s, 0.22±0.02 and(0.97±0.19)×10-3 mm2/s , these values of benign lesions were (1.52±0.19)×10-3 mm2/s, 0.21±0.02 and(1.79±0.19)×10-3 mm2/s, there were statistically significant differences (all P<0.05). Area under the curve of ADC, FA and λ1 were 0.990, 0.605 and 0.978, respectively. The AUC of FA was lower than that of ADC and λ1(P<0.01, <0.01), but there was no difference between the AUC of ADC and that of λ1(P=0.131 6). The sensitivity DCE-MRI combined with ADC and DCE-MRI combined with λ1 was 88.6% vs 97.1%(P=0.353 3), the specificity was 84.6% vs 97.4%(P=0.113 0). Conclusion ADC and λ1 is helpful to differentiate malignant from benign in mass lesions. Key words: Breast neoplasms; Magnetic resonance imaging; Diffusion tensor imaging