Diagnostic value of dynamic contrast enhanced magnetic resonance imaging combined with diffusion weighted imaging quantitative analysis in ductal carcinoma in situ with microinvasion
Abstract:Objective To investigate the diagnostic value of dynamic contrast enhanced magnetic resonance imaging combined with diffusion weighted imaging quantitative analysis in ductal carcinoma in situ with microinvasion. Methods A total of 100 patients with early breast cancer who were diagnosed by DCE-MRI combined with DWI in Xinyu People′s Hospital from March 2018 to January 2020 were retrospectively analyzed, and divided into the control group(60 patients who were diagnosed as ductal carcinoma in situ, DCIS, by the pathological examination) and the observation group (40 patients who were diagnosed as DCIS-Mi by the pathological examination), according to the difference of diagnosis types in the pathological examination. The apparent diffusion coefficient (ADC), early-phase enhancement rate (EER) and the characteristics in different MRI enhancement types were compared between the two groups. Results The ADCMin of the observation group was lower than that of the control group, and the ADCDR and EER of the observation group were higher than those of the control group, with statistically significant differences (P<0.05), while the ADCMax difference between the two groups was not statistically significant (P>0.05). No significant differences were observed in the numbers of non-phymatoid enhancement cases and phymatoid enhancement cases between the two groups (P>0.05). The non-phymatoid enhancement characteristics was compared between the two groups, the internal enhancement characteristics was compared between the two groups, with statistically significant difference (P<0.05). The proportion of homogeneous enhancement cases in the observation group was lower than that in the control group, while the proportion of heterogeneous enhancement cases was higher than that in the control group, with statistically significant differences (P<0.05). The distribution characteristics was compared between the two groups, with statistically significant (P<0.05). The proportion of cases of focal distribution in the observation group was lower than that in the control group, and the proportion of cases of segment distribution in the observation group was higher than that in the control group, with statistically significant differences (P<0.05). The differences in the characteristics of phymatoid enhancement between the two groups were statistically significant (P<0.05). The proportion of homogeneous enhancement cases in the observation group was lower than that in the control group, while the proportion of ring enhancement cases in the observation group was higher than that in the control group, with statistically significant differences (P<0.05). The proportion of cases with unclear lesion edge in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). No significant differences were observed between the two groups in all of the proportions of lesions in the shape (P>0.05). Conclusion DWI combined with DCE-MRI has a good diagnostic efficacy for DCIS-Mi, and the differential diagnosis of DCIS alone and DCIS- Mi can be performed based on lesion distribution and internal enhancement characteristics.