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• Clinical Article •
Application value of synthetic MRI in the differential diagnosis of benign and malignant breast lesions with peripheral rim enhancement
TONG Qiuyun  YU Xueyan  LI Xun  JIANG Yu  DAI Wenhai  ZHOU Zhipeng 

Cite this article as: TONG Q Y, YU X Y, LI X, et al. Application value of synthetic MRI in the differential diagnosis of benign and malignant breast lesions with peripheral rim enhancement[J]. Chin J Magn Reson Imaging, 2023, 14(10): 78-83. DOI:10.12015/issn.1674-8034.2023.10.014.


[Abstract] Objective To explore the application value of synthetic MRI (syMRI) in the differential diagnosis of benign and malignant breast lesions with peripheral rim enhancement.Materials and Methods A total of 52 patients (54 breast lesions with peripheral rim enhancement) which underwent MRI examination were included in the study. All subjects underwent plain scan and enhanced scan of syMRI, diffusion weighted imaging scan and dynamic contrast-enhanced imaging MRI (DCE-MRI) scan, and then all of them received pathology results by surgery or biopsy within one week after MRI examination. The T1, T2, PD values of breast lesions pre-contrast and post-contrast injection (T1pre, T2pre, and PDpre; T1post, T2post, and PDpost) were estimated from syMRI data by using syMRI post-processing software. The relative change rate was calculated (ΔT1%, ΔT2%, ΔPD%). The apparent diffusion coefficient (ADC) values of the ring wall and inside the ring were measured. According to the result of pathology, all lesions were divided into benign and malignant groups. Independent sample t-test and Wilcoxon rank-sum test were used to analyze whether the data were significantly different (P＜0.05). The χ2 test or Fisher exact test were used to analyze the image features of DCE-MRI [morphology, edge and time-signal intensity curve (TIC)]. Logistic regression was used to establish single-factor and multi-factor prediction models for statistically significant parameters, and the ROC curve of the subjects was drawn and the diagnosis efficiency of the prediction model was evaluated by DeLong test.Results In 54 lesions, malignant 42 cases, 12 cases were benign. The T2pre of benign groups [101.17 (28.42)] higher than malignant group [88.67 (21.75)], the PDpost of benign groups (101.90±14.60) higher than malignant group (84.90±20.00). There were significant differences in TIC (P＜0.001) and the ADC values of the ring wall (P＜0.001) between benign and malignant groups (P＜0.05). The area under the curve (AUC) of PDpost was 0.763 and higher than T2pre (AUC=0.758), lower than TIC (AUC=0.883) and the ADC values of the ring wall (AUC=0.901). The diagnosis efficiency of the ADC values of the ring wall was highest when applied separately. When the parameters were used together, the multi-factor model combined by the four joint parameters diagnosis efficiency highest (AUC=0.998). As a single parameter, the diagnosis efficiency of TIC type, T2pre and PDpost was statistically different from that of the multi-factor model combined by the four joint parameters (P＜0.05), but the diagnosis efficiency of the ADC values of the ring wall was not statistically different from that of the multi-factor model combined by the four joint parameters (P＞0.05).Conclusions T2pre and PDpost obtained using syMRI can be used as an auxiliary means for diagnosis of benign and malignant breast lesions with peripheral rim enhancement, the diagnosis efficiency is lower than TIC and the ADC values of the ring wall when applied separately, and the diagnosis efficiency of combined application with TIC and the ADC values of the ring is highest. The diagnosis efficiency of the ADC values of the ring wall is not statistically different from that of the multi-factor model combined by the four joint parameters.
[Keywords] breast；peripheral rim enhancement；differential diagnosis；synthetic magnetic resonance imaging；magnetic resonance imaging

TONG Qiuyun   YU Xueyan   LI Xun   JIANG Yu   DAI Wenhai   ZHOU Zhipeng*  

Department of Medical Imaging, Affiliated Hospital of Guilin Medical University, Guilin 541001, China

Corresponding author: ZHOU Z P, E-mail: bigbird_zhou@hotmail.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Guangxi Self-Funded Scientific Research Project (No. Z20201476).
Received  2023-04-15
Accepted  2023-09-28
DOI: 10.12015/issn.1674-8034.2023.10.014
Cite this article as: TONG Q Y, YU X Y, LI X, et al. Application value of synthetic MRI in the differential diagnosis of benign and malignant breast lesions with peripheral rim enhancement[J]. Chin J Magn Reson Imaging, 2023, 14(10): 78-83. DOI:10.12015/issn.1674-8034.2023.10.014.

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