基于DCE-MRI的3D-MIP重建及多参数评估BI-RADS 4类乳腺肿瘤OA北大核心CSTPCD

Objective:To ascertain whether dynamic contrast-enhancement MRI(DCE-MRI)is a useful diagnostic tool for intratumoral and peritumoral vascular features in breast imaging reporting and data system(BI-RADS)4 of tumors.Materials and Methods:A retrospective collection of 102 female cases with BI-RADS4 breast MRI examination and clear pathological results from August 2018 to March 2023 at the First Affiliated Hospital of Dalian Medical University,43 cases were benign group and 59 cases were breast malignant group.Record the patient's age,maximum lesion diameter(dmax),and basic imaging features of breast DCE-MRI,as well as peritumor vascular characteristics and intratumor hemodynamic parameters.Differences in several parameters between the two groups were analyzed by univariate and multivariate Logit models.The diagnostic efficacy of combining various peritumor vascular characteristic indexes and intratumor parameter values to differentiate between benign and malignant BI-RADS4 lesions in the breast was analysed using the receiver operating characteristic,(ROC)curves and the area under the curve(AUC).Evaluate AUC with the DeLong test.Results:There were statistically significant differences in number of adjacent vascular signs(AVS),maximum diameter(dmax)of peritumoral blood vessels,the difference in diameter of blood vessels around the tumor between the affected and healthy sides(∆d),peritumoral vascular appearance phase,volume transfer constant(Ktrans),flux rate constant(Kep),maximum slope of enhancement(MSI),type of time signal intensity curve(TIC),background parenchymal enhancement(BPE)and fibrous glandular tissue(FGT)between the two groups of benign and malignant breast cases(P<0.05),while there was no statistically significant difference between signal enhancement ratio(SER)and volume fraction of extracellular space(Ve)(P>0.05).∆d,dmax,MSI and Ktrans were independent factors that affected how the two groups differentiated from one another,according to multiple logistic regression analysis,with MSI values having the largest predominance ratio(AUC of 0.923).Comparing peritumor vascular characteristic indexes(∆d)with dmax,MSI,and Ktrans,the combined model of ∆d and MSI showed the highest diagnostic performance(AUC value of 0.933,sensitivity and specificity of 93.2%and 83.7%,respectively),and the difference between ∆d combined with MSI and ∆d combined with Ktrans was statistically significant(P=0.001);When comparing additional joint indicators pairwise,there was no statistically significant difference(P>0.05).The joint model performed better diagnostically than the individual MSI model.Conclusions:The combination of peritumoral vascular characteristic indexes(∆d)and intratumoral semi quantitative parameters(MSI)has high application value in identifying benign and malignant breast lesions in BI-RADS4.