The diagnostic value of MRI multi-parameter combination for breast lesions with ring enhancement

To investigate the diagnostic value of MRI multi-parameter combination for breast lesions with ring enhancement (internal enhancement pattern) on dynamic contrast-enhanced (DCE)-MRI.

149 patients with histologically confirmed breast lesions underwent DCE-MRI and diffusion-weighted imaging (DWI) examinations were analyzed. Sixty-seven lesions were found and were allocated into the benign group and the malignant group. The pathological results were used as dependent variables, indexes with statistical differences were used as independent variables, and logistic regression model was performed to construct the newly combined parameters and to evaluate the diagnostic efficacy of the stepwise combined parameters.

There were significant differences in the number of cases with different wall shapes concerning"enhanced ring" and the number of cases with wall nodules between the benign and the malignant group. Significant differences were found in the number of cases with different distribution locations of limited diffusion on DWI between the benign and the malignant group. There were significant differences in the semi-quantitative parameters including early enhancement ratio (EER) and maximum enhancement time (Tmax) between the benign group and the malignant group. There were significant differences in apparent diffusion coefficient (ADC) ring inner and ADC ring wall between the benign and the malignant group. The maximum Youden index of a newly-constructed parameter combination: morphological indexes of "enhanced ring" + distribution locations of limited diffusion on DWI + Tmax + ADC ring inner was 0.732 for combined diagnosis, the area under the ROC curve (Az) was 0.887, and the diagnostic sensitivity and specificity were 85.78 and 87.37%, respectively.

MRI multi-parameter combination can improve the diagnostic efficacy of breast lesions with ring enhancement.