Journal of Capital Medical University ›› 2018, Vol. 39 ›› Issue (2): 190-194.doi: 10.3969/j.issn.1006-7795.2018.02.007

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Multi-parameters quantitative analysis of breast infiltrating ductal carcinoma as measured by diffusion weighted imaging and dynamic enhancement

Peng Nan1, Liu Huimin2, Wang Weixin1, Liu Ming1, Wang Zhiqun1   

  1. 1. Department of Radiology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing 100078, China;
    2. Department of Pathology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing 100078, China
  • Received:2018-02-27 Online:2018-03-21 Published:2018-04-14
  • Supported by:
    This study was supported by Natural Science Foundation of Beijing(7152069), Project of Capital Clinical Characteristic Application of Beijing Science and Technology Commission(Z151100004015061), Beijing Science and Technology Development Fund Project of Traditional Chinese Medicine (QN2016-09), Capital Health Development Research Project (2018-1-2122).

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Abstract: Objective To analyze the imaging features of magnetic resonance diffusion weighted imaging (DWI) and dynamic enhanced scan in invasive ductal carcinoma of the breast. Methods Data of 32 cases of breast invasive ductal carcinoma confirmed by surgical operation or biopsy pathology were collected,the patients's age ranged from 31 to 77, average (56±11.60) years. All patients underwent routine breast magnetic resonance imaging (T1WI, T2WI), DWI and dynamic enhanced scanning. Images of the 32 patients were analyzed, including lesion location, DWI characteristics, apparent diffusion coefficient (ADC) values, morphological and characteristic of enhancement, and type of dynamic enhancement curve.The signal enhancement ratio(SER)was calculated. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of SER. The statistically significant differences were set at P<0.05. Results The lesions mainly located in the external upper quadrant, a total of 16 cases (50%), followed by the inner and upper quadrant, 7 cases (21.9%), 5 cases (15.6%) posterior to the nipple, 3 cases (9.4%) in the inferior and outer quadrant, 1 case (3.1%) of multifocal lesions in different regions. DWI showed 23 cases of hyperintense signal, 7 cases of uneven or ring-shaped hyperintense signals, and 2 cases of mild hyperintense signals. The mean ADC was (0.910±0.231)×10-3 mm2/s, which was significantly lower than that of the contralateral breast tissue (P<0.001). ROC analysis showed that the area under the curve(AUC) of ADC was 0.92, the best diagnostic value was 1.178×10-3mm2/s, the sensitivity was 81.3%, and the specificity was 90.6%. Lump or nodular enhancement was found in 30 cases,with lobulation or speculation, and 2 cases showed non mass like enhancement. Edge centrality enhancement or multiple small ring enhancement was found in 30 cases; addtionally,1 case of center enhancement and 1 case of homogeneous enhancement were also found. The dynamic enhancement curve showed outflow type in 26 cases, platform type of 5 cases, and progressive type of 1 case, with significant difference. ROC analysis showed that the AUC of ADC was 0.912, the best diagnostic value was 0.857, the sensitivity was 96.8%, the specificity was 83.9%.Conclusion Breast infiltrating ductal carcinoma lesions mainly located in the two upper quadrant, with nodule or mass type, irregular edges with lobulation and spiky change. DWI signals were elevated to varying degrees and ADC values decreased.The early obvious enhancement were revealed on the lesions, strengthening on the edge or small annular enhancement.The most common type of enhancement curves were the outflow type. The SER significantly increased, which was helpful for the differential diagnosis.

Key words: invasive ductal carcinoma of the breast, magnetic resonance imging, dynamic enhancement, diffusion-weighted imaging

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