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• Clinical Article •
MRI differential diagnosis of breast adenosis and breast ductal carcinoma with pathological correlation
ZHU Dan  QIAN Hai-shan  HAN Hong-xiu  LIANG Xi-zi  ZHAO Jiang-min 

DOI:10.12015/issn.1674-8034.2017.10.007.


[Abstract] Objective: To investigate the radiological features of breast adenosis and breast ductal carcinoma by dynamic contrast enhanced MRI (DCE-MRI), DWI and to correlate them to different pathological types.Materials and Methods: 105 cases of breast adenosis and 78 cases of breast ductal carcinoma confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study. All of the patients were examined preoperatively by DWI and DCE-MRI (Vibrant). MRI features of breast adenosis and breast ductal carcinoma with pathological correlation were analyzed. Clinical data, lesion location, size, pattern and enhancement pattern in the groups between different pathological types of breast adenosis and breast ductal carcinoma were evaluated and analyzed by using statistics test by using χ2 test. One-way ANOVA was employed to compare the ADC values.Results: In 105 cases of breast adenosis, DCE MR images showed mass-like lesions (50 patients) and nonmass-like lesions (55 patients), In 78 cases of breast ductal carcinoma, DCE MR images showed mass-like lesions (52 patients) and nonmass-like lesions (26 patients). Most of MLE lesions of adenosis group have morphological rules (37/50, 74%) and clear edge (35/50, 70%). There were statistical significance between MLE lesions of breast adenosis and breast ductal carcinoma in enhancement pattern and TIC pattern (χ2=14.169 and 13.955, respectively, all P<0.01). The ADC values of MLE lesions of breast adenosis and ductal carcinoma were (131.63±21.8) ×10-3 mm2/s, (104.21±18.54) ×10-3 mm2/s, respectively. There were significant differences in the groups (F=52.167, P<0.01). NMLE lesions of breast adenosis and breast ductal carcinoma enhancement patterns were diverse. There were statistical significance between NMLE lesions in pattern and TIC pattern (χ2=and 4.478, respectively, all P<0.05). The ADC values of MLE lesions of breast adenosis and ductal carcinoma were (136.23±14.8) ×10-3 mm2/s, (102.51±16.44) ×10-3 mm2/s, respectively. There were significant differences between the groups (F=49.167, P<0.01).Conclusion: The characteristic of radiological findings can be found in breast adenosis using advanced MR imaging techniques, most of MLE lesions of breast adenosis are benignity-looking lesions, and NMLE lesions of breast adenosis in morphology are similar to malignant lesions, DCE-MRI combined with DWI are helpful in the differential diagnosis of breast ductal carcinoma. It shows these suspicious features could be misleading in the MRI interpretation in a group of patients with stromal fibrosis.
[Keywords] Breast diseases；Carcinoma, ductal, breast；Magnetic resonance imaging；Sclerosing adenosis；Diffusion weighted imaging

ZHU Dan Department of Medical Imaging, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 201999, China

QIAN Hai-shan Department of Medical Imaging, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 201999, China

HAN Hong-xiu Department of Pathology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 201999, China

LIANG Xi-zi Department of Pathology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 201999, China

ZHAO Jiang-min* Department of Medical Imaging, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 201999, China

*Correspondence to: Zhao JM, E-mail: johnmzhao@sjtu.edu.cn

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Science and Technology Commission Research Fund of Baoshan District of Shanghai No.14-E-4
Received  2017-02-12
Accepted  2017-04-19
DOI: 10.12015/issn.1674-8034.2017.10.007
DOI:10.12015/issn.1674-8034.2017.10.007.

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