Role of dynamic contrast-enhancement combined with intravoxel incoherent motion diffusion-weighted MRI at 3.0T in differentiating benign from malignant breast lesions

Objective To evaluate dynamic contrast-enhancement combined with intravoxel incoherent motion (IVIM) diffusion-weighted (DW) MRI for differentiating benign from malignant breast lesions. Methods The clinical data of 60 cases of breast diseases confirmed by pathology in our hospital from October, 2016 to September, 2017 were retrospectively analyzed (benign:25 cases, malignant:35 cases). Conventional MRI, dynamic contrast enhancement and IVIM-DWI (b=0-1 200 s/mm²) examination were performed in all patients. Lesion morphology, enhancement pattern, time signal curve and the relevant parameters of IVIM model were analyzed to evaluate the differential diagnostic value between breast benign and malignant lesions respectively. Results The irregular margin with or without spiculation and heterogeneous enhancement were mostly seen in breast cancer (P=0.003, 0.004, respectively). TIC type Ⅲ was mostly seen in breast cancer, TIC type Ⅰ and Ⅱ were mostly seen in breast benign (χ²=19.272, P<0.01). Except D^* value, there were statistically significant differences among the IVIM related parameters (t=3.301, -5.247, 3.899, all P<0.05). ROC analysis showed that the AUC of D value was 0.873 which was the highest one. AUC was increased to 0.941 by combining D with f value for diagnosis. Conclusion Magnetic resonance dynamic contrast enhancement combined with IVIM model related parameter values can improve the value of differentiating benign from malignant breast lesions, and shows a higher diagnostic efficiency.