Comparative Study of Dynamic Contrast-Enhanced Breast MRI, Ultrasound, and X-ray Mammography in Differential Diagnosis of Benign and Malignant Breast Lesions_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YUANHong-mei ^1,2 ,  YUJian-qun ¹ , CHUZhi-gang ¹ , PENGLi-qing ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Department of Ultrasonography, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China;

Corresponding?author：

YUJian-qun, Email: cjr.yujianqun@vip.163.com

Keywords：

Breast tumor; Magnetic resonance imaging; Ultrasound; X-ray; Differential diagnosis

DOI：

10.7507/1007-9424.20150066

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To assess the values of MRI, ultrasound (US), and X-ray in the differential diagnosis of benign and malignant breast lesions. Methods The image data of 50 breast lesions confirmed with histopathology were analyzed retrospectively and the values of MRI, US and X-ray mammography in the differential diagnosis of benign and malignant breast lesions based on the breast imaging reporting and data system (BI-RADS) were assessed. The diagnostic efficiency of MRI, US, and X-ray in 50 benign and malignant breast lesions were compared using receiver operating characteristics (ROC) curves. The areas of ROC curves of MRI, US, and X-ray were calculated with Z test using SPSS 16.0. Results There were 44 patients with 50 breast lesions, 26 malignant lesions, 24 benign lesions. Based on the BI-RADS, according to X-ray imaging features, 26 malignant breast lesions were classified as 5 lesions of category 5, 7 lesions of category 4, 6 lesions of category 3, 3 lesions of category 2, 1 lesion of category 1, 4 lesions of category zero. Twenty-four benign breast lesions were classified as 1 lesion of category 4, 3 lesions of category 3, 4 lesions of category 2, 13 lesions of category 1, 3 lesions of category zero. According to the characteristics of US findings, 26 malignant breast lesions were classified as 17 lesions of category 5, 4 lesions of category 4, 1 lesion of category 3, 1 lesion of category 2, 3 lesions of category 1. Twenty-four benign breast lesions were classified as 1 lesion of category 5, 2 lesions of category 4, 4 lesions of category 3, 14 lesions of category 2, 2 lesions of category 1, 1 lesion of category 0. According to MRI imaging findings, 26 malignant breast lesions were classified as 6 lesions of category 5, 18 lesions of category 4, 1 lesion of category 3, 1 lesion of category 1. Twenty-four benign breast lesions were classified as 20 lesions of category 1, 3 lesions of category 2, 1 lesion of category 3. The area under the ROC curve of the MRI, US, and X-ray was 0.977, 0.835, and 0.764, respectively. The differences of MRI with US (Z=2.05, P < 0.05) and MRI with X-ray mammography (Z=2.81, P < 0.05) were statistically significant. While the difference of US with X-ray mammography (Z=0.73, P > 0.05) was't statistically significant. Conclusions Dynamic contrast-enhanced MRI is an accurate examination in the differential diagnosis of benign and malignant breast lesions. The differential diagnostic efficiency of MRI is significantly better than those with US and X-ray.

Citation： YUANHong-mei, YUJian-qun, CHUZhi-gang, PENGLi-qing. Comparative Study of Dynamic Contrast-Enhanced Breast MRI, Ultrasound, and X-ray Mammography in Differential Diagnosis of Benign and Malignant Breast Lesions. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(2): 246-250. doi: 10.7507/1007-9424.20150066 Copy

1.	?American College of Radiology. Breast imaging reporting and data system (BI-RADS). 4th edition. Reston (VA) 7 American College of Radiology, 2003.
2.	顧雅佳, 肖勤.乳腺X線報告規范化——BI-RADS介紹.中國醫學計算機成像雜志, 2007, 13(5): 322-326.
3.	Mendelson EB, Baum JK, Berg WA, et al. Breast imaging reporting and data system: ultrasound. Reston: American College of Radiology, 2003: 1-81.
4.	Heinig J, Witteler R, Schmitz R, et al. Accuracy of classification of breast ultrasound findings based on criteria used for BI-RADS. Ultrasound Obstet Gynecol, 2008, 32(4): 573-578.
5.	Erguvan-Dogan B, Gj W, Kushwaha AC, et al. BI-RADS-MRI: a primer. AJR Am J Roentgenol, 2006, 187(2): W152-W160.
6.	湯光宇, 肖湘生, 劉勇, 等. MR影像報告數據系統鑒別良惡性乳腺腫塊的價值初探.臨床放射學雜志, 2007, 26(12): 1306-1308.
7.	Kuhl CK, Mielcareck P, Klaschik S, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions. Radiology, 1999, 211(1): 101-110.
8.	邵志敏, 余科達.乳腺外科的發展趨勢.中國普外基礎與臨床雜志, 2007, 14(3): 252-254.
9.	Macura KJ, Ouwerkerk R, Jacobs MA, et al. Patterns of enhancement on breast MR images: interpretation and imaging pitfalls. Radiographics, 2006, 26(6): 1719-1734.
10.	El Khouli RH, Macura KJ, Jacobs MA, et al. Dynamic contrast-enhanced MRI of the breast: quantitative method for kinetic curve type assessment. AJR Am J Roentgenol, 2009, 193(4): W295-W300.
11.	Stavros AT, Thickman D, Rapp CL, et al. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology, 1995, 196(1): 123-134.
12.	Rotten D, Levaillant J, Contancis E, et al. Three-dimensional imaging of solid breast tumours with ultrasound:preliminary data. Ultrasound Obslet Gynecol, 2003, 1(6): 384-390.
13.	Leconte I, Feger C, Galant C, et al. Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density. AJR Am J Roentgenol, 2003, 180(6): 1675-1679.
14.	Hollingsworth AB, Taylor LD, Rhodes DC. Establishing a histologic basis for false-negative mammograms. Am J Surg, 1993, 166(6): 643-648.
15.	張立娜, 黎庶, 鄭新宇, 等.乳腺X線及超聲影像診斷乳腺癌的優勢及不足.中國醫科大學學報, 2010, 39(6): 485-486.
16.	趙立志.超聲在乳腺腫塊鑒別診斷中的應用.現代中西醫結合雜志, 2009, 18(7): 803, 838.
17.	Raza S, Goldkamp AL, Chikarmane SA, et al. US of breast masses categorized as BI-RADS 3, 4, and 5: pictorial review of factors influ-encing clinical management. Radiographics, 2010, 30(5): 1199-1213.
18.	馬步云, 彭玉蘭, 羅燕, 等.超聲診斷乳腺癌的漏診和誤診分析.華西醫學, 2007, 22(1): 16-17.
19.	Stanzani D, Chala LF, Barros N, et al. Can doppler or contrast-enh-anced ultrasound analysis add diagnostically important information about the nature of breast lesions. Clinics (Sao Paulo), 2014, 69(2): 87-92.
20.	袁紅梅, 劉健, 高硯春, 等.超聲引導下Mammotome微創旋切術在乳腺良性病變中的應用.川北醫學院學報, 2011, 26(6): 493-496.
21.	張麗芝, 曾涵江, 黃子星, 等.乳腺浸潤性導管癌的MRI診斷價值.中國普外基礎與臨床雜志, 2012, 19(9): 1008-1011.
22.	Yang Q, Li LH, Zhang J, et al. Computer-aided diagnosis of breast DCE-MRI images using bilateral asymmetry of contrast enhancement between two breasts. J Digit Imaging, 2014, 27(1): 152-160.
23.	Schnall MD, Rosten S, Englander S, et al. A combined architectural and kinetic interpretation model for breast MR images. Acad Radiol, 2001, 8(7): 591-597.
24.	黃娟, 余建群.乳腺腫塊型浸潤性導管癌MRI動態增強掃描征象與WHO病理分級的關系.中國普外基礎與臨床雜志, 2014, 21(5): 636-640.
25.	Biglia N, Bounous VE, Martincich L, et al. Role of MRI (magnetic resonance imaging) versus conventional imaging for breast cancer presurgical staging in young women or with dense breast. Eur J Surg Oncol, 2011, 37(3): 199-204.

1. ?American College of Radiology. Breast imaging reporting and data system (BI-RADS). 4th edition. Reston (VA) 7 American College of Radiology, 2003.
2. 顧雅佳, 肖勤.乳腺X線報告規范化——BI-RADS介紹.中國醫學計算機成像雜志, 2007, 13(5): 322-326.
3. Mendelson EB, Baum JK, Berg WA, et al. Breast imaging reporting and data system: ultrasound. Reston: American College of Radiology, 2003: 1-81.
4. Heinig J, Witteler R, Schmitz R, et al. Accuracy of classification of breast ultrasound findings based on criteria used for BI-RADS. Ultrasound Obstet Gynecol, 2008, 32(4): 573-578.
5. Erguvan-Dogan B, Gj W, Kushwaha AC, et al. BI-RADS-MRI: a primer. AJR Am J Roentgenol, 2006, 187(2): W152-W160.
6. 湯光宇, 肖湘生, 劉勇, 等. MR影像報告數據系統鑒別良惡性乳腺腫塊的價值初探.臨床放射學雜志, 2007, 26(12): 1306-1308.
7. Kuhl CK, Mielcareck P, Klaschik S, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions. Radiology, 1999, 211(1): 101-110.
8. 邵志敏, 余科達.乳腺外科的發展趨勢.中國普外基礎與臨床雜志, 2007, 14(3): 252-254.
9. Macura KJ, Ouwerkerk R, Jacobs MA, et al. Patterns of enhancement on breast MR images: interpretation and imaging pitfalls. Radiographics, 2006, 26(6): 1719-1734.
10. El Khouli RH, Macura KJ, Jacobs MA, et al. Dynamic contrast-enhanced MRI of the breast: quantitative method for kinetic curve type assessment. AJR Am J Roentgenol, 2009, 193(4): W295-W300.
11. Stavros AT, Thickman D, Rapp CL, et al. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology, 1995, 196(1): 123-134.
12. Rotten D, Levaillant J, Contancis E, et al. Three-dimensional imaging of solid breast tumours with ultrasound:preliminary data. Ultrasound Obslet Gynecol, 2003, 1(6): 384-390.
13. Leconte I, Feger C, Galant C, et al. Mammography and subsequent whole-breast sonography of nonpalpable breast cancers: the importance of radiologic breast density. AJR Am J Roentgenol, 2003, 180(6): 1675-1679.
14. Hollingsworth AB, Taylor LD, Rhodes DC. Establishing a histologic basis for false-negative mammograms. Am J Surg, 1993, 166(6): 643-648.
15. 張立娜, 黎庶, 鄭新宇, 等.乳腺X線及超聲影像診斷乳腺癌的優勢及不足.中國醫科大學學報, 2010, 39(6): 485-486.
16. 趙立志.超聲在乳腺腫塊鑒別診斷中的應用.現代中西醫結合雜志, 2009, 18(7): 803, 838.
17. Raza S, Goldkamp AL, Chikarmane SA, et al. US of breast masses categorized as BI-RADS 3, 4, and 5: pictorial review of factors influ-encing clinical management. Radiographics, 2010, 30(5): 1199-1213.
18. 馬步云, 彭玉蘭, 羅燕, 等.超聲診斷乳腺癌的漏診和誤診分析.華西醫學, 2007, 22(1): 16-17.
19. Stanzani D, Chala LF, Barros N, et al. Can doppler or contrast-enh-anced ultrasound analysis add diagnostically important information about the nature of breast lesions. Clinics (Sao Paulo), 2014, 69(2): 87-92.
20. 袁紅梅, 劉健, 高硯春, 等.超聲引導下Mammotome微創旋切術在乳腺良性病變中的應用.川北醫學院學報, 2011, 26(6): 493-496.
21. 張麗芝, 曾涵江, 黃子星, 等.乳腺浸潤性導管癌的MRI診斷價值.中國普外基礎與臨床雜志, 2012, 19(9): 1008-1011.
22. Yang Q, Li LH, Zhang J, et al. Computer-aided diagnosis of breast DCE-MRI images using bilateral asymmetry of contrast enhancement between two breasts. J Digit Imaging, 2014, 27(1): 152-160.
23. Schnall MD, Rosten S, Englander S, et al. A combined architectural and kinetic interpretation model for breast MR images. Acad Radiol, 2001, 8(7): 591-597.
24. 黃娟, 余建群.乳腺腫塊型浸潤性導管癌MRI動態增強掃描征象與WHO病理分級的關系.中國普外基礎與臨床雜志, 2014, 21(5): 636-640.
25. Biglia N, Bounous VE, Martincich L, et al. Role of MRI (magnetic resonance imaging) versus conventional imaging for breast cancer presurgical staging in young women or with dense breast. Eur J Surg Oncol, 2011, 37(3): 199-204.

Previous Article
大隱靜脈曲張術后復發22例患者的臨床分析
Next Article
Research Progress of microRNA in Regulating Tumor Microenvironment

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparative Study of Dynamic Contrast-Enhanced Breast MRI, Ultrasound, and X-ray Mammography in Differential Diagnosis of Benign and Malignant Breast Lesions

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content