Diagnostic value of diffusion-weighted imaging combined with MRI dynamic contrast-enhanced imaging on BI-RADS grade 3-4 lesions
FAN Ju
PENG Chuanyong
WANG Jiajia
Abstract：Objective To analyze the diagnostic value of diffusion-weighted imaging(DWI)and MRI dynamic contrast-enhanced imaging on breast imaging reporting and data system(BI-RADS)grade 3-4 lesions.Methods A retrospective analysis design was used.The data of 130 patients with BI-RADS grade 3-4 lesions in our hospital from March 2023 to August 2024 were collected.According to the pathological results,patients with benign lesions were set as benign group,and patients with malignant lesions were regarded as malignant group.The various parameters and imaging characteristics of DWI and MRI dynamic scans were compared between the two groups.Random splitting method was adopted to split the data into training set and validation set(random seed value=1 234).Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of BI-RADS grade 3-4 lesions.ROC curve and Hosmer-Lemeshow test were used to evaluate the predictive ability and fitting degree of combined prediction model.ROC curve was applied to analyze the diagnostic efficiency of apparent diffusion coefficient(ADC),mean diffusion coefficient(MD)and kurtosis coefficient(MK)on malignant transformation of BI-RADS grade 3-4 lesions.Results A total of 130 mass lesions were found in 130 patients with BI-RADS grade 3-4 lesions,and biopsy or surgical pathology confirmed 69 malignant cases and 61 benign cases.There were statistically significant differences in age,internal enhancement characteristics,ADC,MD,MK and time-signal curve(TIC)classification between malignant group and benign group(P<0.05).Multivariate Logistic regression analysis and stepwise regression analysis revealed that TIC classification(outflow type),increased age,decreased ADC,decreased MD,and increased MK were independent risk factors of malignant transformation of BI-RADS grade 3-4 lesions(P<0.05).In the training set,the AUC,sensitivity and specificity of the model were 0.948(95%CI:0.908-0.988),90.48%and 85.71%.The AUC,sensitivity and specificity of the model in the validation set were 0.947(95%CI:0.878-1.000),94.74%and 70.00%respectively.ROC curve analysis showed that the optimal cut-off values of ADC,MD and MK in the diagnosis of malignant transformation of BI-RADS grade 3-4 lesions were≤1.21(AUC:0.834,sensitivity:73.91%,specificity:80.33%,95%CI:0.764-0.904),≤1.44(AUC:1.44,sensitivity:75.36%,specificity:65.57%,95%CI:0.649-0.821)and>0.75(AUC:0.731,sensitivity:55.07%,specificity:85.25%,95%CI:0.645-0.816)respectively.Conclusion DWI combined with dynamic contrast-enhanced imaging has diagnostic value on malignant transformation of BI-RADS grade 3-4 lesions,and TIC classification,ADC,MD and MK can be used as diagnostic indicators.
Keywords：breast lesionsmagnetic resonance imagingdynamic contrast-enhanced imagingdiffusion weighted imagingbreast imaging reporting and data system
Publication Date：2025-10-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：7( 1289-1295 )