Objective To explore the differential diagnosis significance of 3.0T MRI united-sequences examination in the diagnosis of benign and malignant breast lesions. Methods A total of 67 breast lesions of 59 patients were collected prospectively, which be treated at the Sichuan Provincial People’s Hospital during July 2015 to January 2017. All patients were underwent bilateral breast 3.0T magnetic resonance plain scan, diffusion weighted imaging, and dynamic enhanced scan successively before surgical operation. Analysis of morphological features of the benign and malignant breast lesions, the time-signal intensity curve (TIC), the apparent diffusion coefficient (ADC), and the combination diagnosis of them were performed. Results Of all 59 patients, 67 lesions were confirmed by histopathology, including 18 benign lesions and 49 malignant lesions. The morphological features (including margin, shape, border, and evenness), the types of TIC of dynamic enhancement, and ADC value between the benign lesions and malignant lesions were statistically significant (P<0.05). The sensitivity and specificity of Fischer scoring system was 89.8% (44/49) and 61.1% (11/18) respectively. The sensitivity and specificity of TIC types was 83.7% (41/49) and 77.8% (14/18) respectively. The diagnostic threshold of ADC value was 1.012×10–3 mm2/s, with the sensitivity and specificity for the diagnosis was 91.8% (45/49) and 83.3% (15/18) respectively. The sensitivity and specificity of the combination of Fischer scoring system and TIC type for diagnosis between benign and malignant breast lesions was 95.9% (47/49) and 72.2% (13/18) respectively. The sensitivity and specificity of the combination of Fischer scoring system, TIC type, and ADC value for benign and malignant breast lesions was 98.0% (48/49) and 83.3% (15/18) respectively. Conclusion The combination of Fischer scoring system, TIC type, and diffusion-weighted imaging for the differential diagnosis between benign lesions and malignant lesions was more effective than single imaging method.
ObjectiveTo compare the value of apparent diffusion coefficients (ADCs) of MR-DWI at different b values in evaluating the progression of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).MethodsAll of 168 patients with HCC who met the inclusion and exclusion criteria and received the TACE for the first time in the Characteristic Medical Center of PAPF were collected retrospectively, who were divided into a stable group and progressive group according to the results of MRI evaluation at the 6th month after the TACE treatment. The clinical and imaging data of the two groups were compared before the TACE treatment. The Cox proportional hazard regression model was used to analyze the risk factors for the disease progression after the TACE treatment. The receiver operating characteristic curve (ROC) was used to analyze the predicting of efficacy evaluation of TACE by the ADC values at different b values.ResultsCompared with the stable group, the proportions of hepatitis B cirrhosis history, portal vein tumor thrombus, and arteriovenous fistula were higher (P<0.05), and the BCLC stage and Child Pugh grade were worse (P<0.05), and the ADC values were higher (P<0.05) in the progressive group. The results of Cox analysis showed that the ADC values at b=600 and 800 s/mm2 before the TACE, history of hepatitis B cirrhosis, portal vein tumor thrombus, arteriovenous fistula, advanced BCLC stage and Child-Pugh grade were the risk factors for the progression at the 6th month after the TACE treatment. When the b value was 800 s/mm2, the ADC value had the highest efficacy in predicting the outcome of patients (area under ROC curve was 0.746), and the best diagnostic cut-off point was 1.20×10–3 mm2/s, the sensitivity was 73.3% and the specificity was 71.8%.ConclusionADC value of MR-DWI could predict progression after TACE in patients with HCC, and ADC value of 800 s/mm2 has a better predictive value for them.