Objective:The aim of the study was to further explore the diagnostic value of breast dynamic contrast enhancement (DCE), and improve specificity of breast cancer diagnosis. Methods:The 93 patients with 105 breast mass...Objective:The aim of the study was to further explore the diagnostic value of breast dynamic contrast enhancement (DCE), and improve specificity of breast cancer diagnosis. Methods:The 93 patients with 105 breast masses were performed with routine magnetic resonance (MR) scan and DCE scan. Results:1. Morphological manifestations and pathologic findings:105 masses of enhance forms could be divided into six types:(1) No enhancement, 9 masses (breast cyst); (2) The heterogeneous enhancement, 31 masses (fiber adenoma, 9; breast cancer, 11; mammary gland hyperplasia, 10; leafy tumor, 1); (3) The unheterogeneous enhancement, 42 masses (fiber adenoma, 5; the hyperplasia, 3; breast cancer, 33; leafy tumor, 1); (4) Ring enhancement, 17 masses (breast cancer, 15; fiber adenoma, 1 and inflammation, 1); (5) Reticular enhancement, 2 cases (gigantic breast, 1 and inflammation, 1). (6) Duct shape enhancement, 4 (hyperplasia, 1; duct carcinoma, 3). 2. Enhancement slope and pathology results:The maximum slope in 62 malignant masses was equally 19.19 ± 8.13, maximum slopes in 43 benign masses was equally 9.46 ± 6.64, the difference had a very significance (P < 0.01). In 42 masses with II type curves, the maximum slope of 24 malignant focuses were 17.52 ± 6.39, while 18 benign focuses 8.33 ± 5.47, the difference had a very significance (P < 0.01). Use a test-receiver to work curve (ROC curve) progress analysis, with 14.85 for critical point, sensibility for 67%, specificity for 83%; with 17.10 for critical value, the specificity was 100%. 3. Curve type and pathological results:According to general type standard, type I of single-phase curve, 20 masses; type II of platform type curve, 42 and III type curve type of washout, 43. A group of six kinds of forms were as follows:(1) No increased signal strength curve, 9 (cyst); (2) The curve signal strength slowly increasing, 6 (hyperplasia 2, fiber adenoma 2, chronic inflammation 1, duct carcinoma 1); (3) The intensity of curve after rapid increase early, continued to increase slowly 5 (hyperplasia 4, inflammatory breast cancer 1); (4) Curve early signal strength increasing rapidly formed the stop after middle-late platform (platform type), 42 (hyperplasia 9, fiber adenoma 8, leafy tumor 1, and breast cancer 24); (5) Early signal strength rapid increase arrived the peak then rapid declined (outflow type), 40 (hyperplasia 1, fiber adenoma 5, leafy tumor 1, breast 33); (6) Early signal strength increase quickly reached a peak, after platform period, then rising quickly again, and all of 3 for breast cancer. Conclusion:Enhancement morphological characteristics of breast cancer such as duct or ring enhancement had diagnostic value. Maximum slope in benign or malignant lesions, particularly in the differential diagnosis of type II curve played an important role. Formation mechanism of type II curve might be that an obstacle blood backflow of blood vessels by vascular tumor emboli or tumor compression.展开更多
基金Supported by the grant from Guangdong Province Social Development Project (No. 2010133)
文摘Objective:The aim of the study was to further explore the diagnostic value of breast dynamic contrast enhancement (DCE), and improve specificity of breast cancer diagnosis. Methods:The 93 patients with 105 breast masses were performed with routine magnetic resonance (MR) scan and DCE scan. Results:1. Morphological manifestations and pathologic findings:105 masses of enhance forms could be divided into six types:(1) No enhancement, 9 masses (breast cyst); (2) The heterogeneous enhancement, 31 masses (fiber adenoma, 9; breast cancer, 11; mammary gland hyperplasia, 10; leafy tumor, 1); (3) The unheterogeneous enhancement, 42 masses (fiber adenoma, 5; the hyperplasia, 3; breast cancer, 33; leafy tumor, 1); (4) Ring enhancement, 17 masses (breast cancer, 15; fiber adenoma, 1 and inflammation, 1); (5) Reticular enhancement, 2 cases (gigantic breast, 1 and inflammation, 1). (6) Duct shape enhancement, 4 (hyperplasia, 1; duct carcinoma, 3). 2. Enhancement slope and pathology results:The maximum slope in 62 malignant masses was equally 19.19 ± 8.13, maximum slopes in 43 benign masses was equally 9.46 ± 6.64, the difference had a very significance (P < 0.01). In 42 masses with II type curves, the maximum slope of 24 malignant focuses were 17.52 ± 6.39, while 18 benign focuses 8.33 ± 5.47, the difference had a very significance (P < 0.01). Use a test-receiver to work curve (ROC curve) progress analysis, with 14.85 for critical point, sensibility for 67%, specificity for 83%; with 17.10 for critical value, the specificity was 100%. 3. Curve type and pathological results:According to general type standard, type I of single-phase curve, 20 masses; type II of platform type curve, 42 and III type curve type of washout, 43. A group of six kinds of forms were as follows:(1) No increased signal strength curve, 9 (cyst); (2) The curve signal strength slowly increasing, 6 (hyperplasia 2, fiber adenoma 2, chronic inflammation 1, duct carcinoma 1); (3) The intensity of curve after rapid increase early, continued to increase slowly 5 (hyperplasia 4, inflammatory breast cancer 1); (4) Curve early signal strength increasing rapidly formed the stop after middle-late platform (platform type), 42 (hyperplasia 9, fiber adenoma 8, leafy tumor 1, and breast cancer 24); (5) Early signal strength rapid increase arrived the peak then rapid declined (outflow type), 40 (hyperplasia 1, fiber adenoma 5, leafy tumor 1, breast 33); (6) Early signal strength increase quickly reached a peak, after platform period, then rising quickly again, and all of 3 for breast cancer. Conclusion:Enhancement morphological characteristics of breast cancer such as duct or ring enhancement had diagnostic value. Maximum slope in benign or malignant lesions, particularly in the differential diagnosis of type II curve played an important role. Formation mechanism of type II curve might be that an obstacle blood backflow of blood vessels by vascular tumor emboli or tumor compression.
