The diagnostic value of Diffusion-weighted imaging in benign breast inflammatory lesions
Lina Zhang1, Jinli Meng2, Jianxun Qu 3, Jianguo Chu1, Ailian Liu1, Yanwei Miao1, Qingwei Song1, Zhijin Lang1, Jianyun Kang1, Qiang Wei1, and Bin Xu1

1The 1st affiliated hospital of Dalian Medical University, Da lian, China, People's Republic of, 2Chengban Branch of West China Hospital, Chengdu, China, People's Republic of, 3GE Healthcare, MR Research China, Beijing, Beijing, China, People's Republic of


To evaluate the diagnosis value of conventional MRI and Diffusion-weighted imaging in different subtypes of benign inflammation breast lesions. From the result we can see that morphological features as while as MR manifestations especially ADC findings may be of significant value for diagnosing different benign breast inflammatory lesions.


A retrospective study was performed to investigate the diagnostic value of Diffusion-weighted imaging (DWI) in differentiating benign breast inflammatory lesions.


This retrospective study was approved by the institutional review board and requirement for informed consent was waived. Sixty one female patients with pathology-proven single benign breast inflammatory lesion underwent routine MR examination including axial and sagittal STIR, axial DWI with b value of 0 and 800 s/mm2, and 3D DCE MRI acquired with VIBRANT. Both DCE-MRI and DWI results were reviewed. Patients were categorized into three groups based on pathologic results: Nonspecific Mastitis group (NM, 32 patients, age, 41.34 ± 12.71); Abscess group (AB,12 patients, age, 41.33 ± 18.79); and Granulomatous Mastitis group (GM, 17 patients, age, 44.47 ± 14.68). ADC values were recorded. Intra-class correlation coefficient (ICC) was used to test the consistency of the different ADC values. One-way ANOVA test was applied to compare ADC values of the three groups. Logistic analysis was applied to analyze the general data of three groups. Discriminative abilities of models were compared using the area under the receiver operating characteristic curve (AUC). P≤0.05 was considered indicative of a statistically significant difference.


The ICC value of consistency of the two measurement of ADC values for three groups were 0.829, 0.794, and 0.844, the total is 0.853. There was significant difference of the ADC value among three groups (Fig.1, P=0.003). The reliable range of ADC values in diagnosing different kinds of breast inflammatory lesions is as follows: NM> 1.348 × 10-3 mm2/s, AB < 1.125 × 10-3 mm2/s, and 1.125 ×10-3 mm2/s < GM< 1.328 × 10-3 mm2/s (Table1). There was no significant difference between mass and non mass enhancement or mass lesion enhancement characteristics among three groups, while there was significant difference in distribution of non mass enhancement among three groups (Table2). There was also no significant difference in location of lesion, patient age or T2WI signal among three groups.

Discussion and Conclusion

The results of our study indicate that ADC values difference between NM and AB lesions is most, while difference is smallest between AB and GM group, suggesting the degree of inflammation of the inflammatory cells infiltration, tissue necrosis and regeneration of different levels[1]. Some previous studies pay attention to distinguishing inflammation from tumor lesions[2-3]. We analyzed DWI evaluation on different subtypes of inflammation lesions and assume ADC value maybe a potential parameter in classification of inflammation lesions of breast. ADC value is the most efficient indicator in differentiating benign breast inflammatory lesions. Combining morphological features and DWI characteristics, classification of benign breast inflammatory lesions could be performed accurately.


No acknowledgement found.


[1] Tan H, Li R, Peng W, et al.Radiological and clinical features of adult non-puerperal mastitis. Br Radiol. 2013, 86(1024): 20120657 [2] Orguc S, Basara I, Coskun T.Diffusion-weighted MR imaging of the breast: comparison of apparent diffusion coefficient values of normal breast tissue with benign and malignant breast lesions.Singapore Med, 2012, 53(11): 737-743. [3] Ramirez-Galvan YA, Cardona-Huerta S, Ibarra-Fombona E,et al. Apparent diffusion coefficient (ADC) value to evaluate BI-RADS 4 breast lesions: correlation with pathological findings. Clin Imaging, 2015, 39(1): 51-55.


Fig.1 Box plot of ADC value of NM, AB, and GM groups.

Tab.1 AUC of ROC, diagnose threshold, sensitivity and specificity of NM, AB, and GM groups.

Tab.2 Non-mass enhancement comparison among NM, AB, and GM groups

Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)