Value of MRI in diagnosis of benign and malignant breast lesions with cluster ring enhancement

Abstract

Abstract:

ObjectiveTo investigate the diagnostic value of MRI in benign and malignant breast lesions with cluster ring enhancement.MethodsThe imaging signs of 68 patients with clustered ring enhancement who underwent MRI examination due to clinical palpation, ultrasound or X-ray examination for suspected malignant lesions in Tangdu Hospital of Air Force Military Medical University from October 2017 to July 2019 were retrospectively analyzed. The differences between benign and malignant lesions in the distribution pattern, T2 lipid suppression signal intensity, time-signal intensity curve (TIC), ductal dilatation, peripheral gland edema, pectoralis major edema were compared usingχ²test or Mann-WhitneyUtest, and the risk factors of MRI imaging signs of malignant breast lesions were analyzed using binomial logistic regression model.ResultsThere were 68 cluster ring enhancement lesions in 68 patients, all of which were single lesions, among which 18 cases (26.5%) were benign, and the common lesions were plasma cell mastitis (9 cases). Fifty cases (73.5%) were malignant, and the most common type was invasive breast cancer (40 cases). Imaging features of plasma cell mastitis showed cluster ring enhancement, regional distribution, slightly high signal on fat suppression T2 image, type Ⅲ TIC, with ductal dilatation, edema of peripheral glands and pectoralis major. Imaging features of invasive breast cancer showed cluster ring enhancement, regional distribution, iso-signal on fat suppression T2 image, type Ⅲ TIC, no ductal dilatation, and edema of peripheral gland and pectoralis major. There were statistically significant differences in the intensity of fat-suppression T2 signal (Z=3.003,P=0.003) and duct dilatation (χ²=7.174,P=0.007) between benign and malignant lesions. There were no significant differences in distribution (χ²=5.510,P=0.313), TIC type (χ²=3.538,P=0.133), peripheral gland edema (χ²=0.164,P=0.686) and pectoralis major edema (χ²<0.001,P>0.999). The analysis of binomial logistic regression model showed that fat-suppression T2 iso-signal (OR=0.182, 95%CI: 0.036-0.914,P=0.039) and no ductal dilatation (OR=0.198, 95%CI: 0.047-0.846, P=0.029) were the risk factors for breast malignant lesions.ConclusionBreast cancer MRI findings of cluster ring enhancement, fat-suppression T2 iso-signal and no ductal dilatation are related risk factors for malignant breast lesions. MRI is helpful for early detection and diagnosis of breast lesions.

Key words:Breast neoplasms,Magnetic resonance imaging,Cluster ring enhancement,Dynamic enhancement,T2 lipid suppression

Zhang Bei, Zhao Bofeng, Wang Ying, Yu Jun, Chen Ping, Chen Baoying. Value of MRI in diagnosis of benign and malignant breast lesions with cluster ring enhancement[J]. Journal of International Oncology, 2021, 48(9): 527-531.

Figures/Tables4

MRI征象	恶性病变 (n=50)	良性病变 (n=18)	χ²/Z值	P值
分布方式
局灶样	2(4.00)	1(5.60)
线样	2(4.00)	2(11.10)
段样	8(16.00)	6(33.30)	5.510	0.313
区域样	27(54.00)	8(44.40)
多区域样	5(10.00)	0(0.00)
弥漫样	6(12.00)	1(5.60)
T2抑脂信号强度
等	24(48.00)	2(11.10)
稍高	19(38.00)	9(50.00)	3.003	0.003
高	7(14.00)	7(38.90)
TIC类型
Ⅰ型	4(8.00)	2(11.10)
Ⅱ型	3(6.00)	3(16.70)	3.538	0.133
Ⅲ型	43(86.00)	13(72.20)
导管扩张
有	4(8.00)	7(38.90)	7.174	0.007
无	46(92.00)	11(61.10)
周围腺体水肿
有	25(50.00)	10(55.60)	0.164	0.686
无	25(50.00)	8(44.40)
胸大肌水肿
有	13(26.00)	5(27.80)	<0.001	>0.999
无	37(74.00)	13(72.20)

MRI征象	β值	OR值	95%CI	P值	SE值	Wald值
T2抑脂等信号	1.704	0.182	0.036~0.914	0.039	0.824	4.281
无导管扩张	1.617	0.198	0.047~0.846	0.029	0.740	4.777

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