Role of conventional magnetic resonance imaging and diffusion-weighted imaging in evaluation of breast lesions

Mohammed Abdel-Raheem, Hoda Abdel-Samiae, Yasser Ahmed, M. Sleem
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Abstract

Background and Aim This study aimed to evaluate the role of diffusion-weighted imaging (DWI) and apparent diffusion coefficient in diagnosis of the breast lesions. Patients and methods This study included 100 patients referred to the Radiology Department of Al-Azhar Assiut University Hospital from February 2018 to May 2020 for DWI MRI examination with a provisional diagnosis of breast lesions. All patients were recruited after meeting the inclusion criteria. They underwent clinical examination, mammography, ultrasonography, and contrast-enhanced MRI with DWI. Results Our study included 100 cases. The combined MRI protocol of dynamic contrast-enhanced (DCE)-MRI and DWI was true positive in 60 and true negative in 30 patients. The combined MRI protocol of DCE-MRI and DWI provided a sensitivity of 92%, a specificity of 90%, a positive predictive value of 95.8%, a negative predictive value of 81.8% and accuracy of 91.43%. In this study, the addition of DWI to standard DCE-MRI provided a 10% increase in the specificity of breast MRI, with a 4% decrease in the sensitivity. Conclusion DWI is a short unenhanced scan and had the highest specificity compared with other imaging modalities, as it reduced the false-positive results. It should be added to conventional breast MRI to increase the sensitivity and specificity of MRI.
常规磁共振成像和弥散加权成像在乳腺病变评估中的作用
背景与目的探讨乳腺弥散加权成像(DWI)和表观弥散系数对乳腺病变的诊断价值。患者和方法本研究纳入了2018年2月至2020年5月在爱资哈尔阿西尤特大学医院放射科进行DWI MRI检查的100例患者,初步诊断为乳腺病变。所有患者在符合纳入标准后被招募。他们接受了临床检查,乳房x光检查,超声检查和磁共振造影增强与DWI。结果本研究纳入100例病例。动态对比增强(DCE)-MRI和DWI联合MRI方案真阳性60例,真阴性30例。DCE-MRI和DWI联合方案的敏感性为92%,特异性为90%,阳性预测值为95.8%,阴性预测值为81.8%,准确率为91.43%。在本研究中,在标准DCE-MRI的基础上增加DWI,乳房MRI的特异性提高了10%,敏感性降低了4%。结论DWI是一种短时间的非增强扫描,与其他成像方式相比,它的特异性最高,因为它减少了假阳性结果。应在常规乳腺MRI的基础上增加,以提高MRI的敏感性和特异性。
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34 weeks
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