Differential Diagnosis of Benign and Malignant Breast Papillary Neoplasms on MRI With Non-mass Enhancement

作者：Juan Zhou, Mei Li, Dongqing Liu, Fugeng Sheng, Jianming Cai · 发表于：Academic Radiology · 年份：2023 · DOI：10.1016/j.acra.2023.02.010 · 被引用次数：12 · 研究领域：Breast Lesions and Carcinomas、MRI in cancer diagnosis、Digital Radiography and Breast Imaging

RATIONALE AND OBJECTIVES: To explore the differential diagnosis of benign and malignant papillary neoplasms on MRI with non-mass enhancement. MATERIALS AND METHODS: A total of 48 patients with surgically confirmed papillary neoplasms showing non-mass enhancement were included. Clinical findings, mammography and MRI features were retrospectively analyzed, and lesions were described according to the breast imaging report and data system (BI-RADS). Multivariate analysis of variance was used to compare the clinical and imaging features of benign and malignant lesions. RESULTS: Fifty-three papillary neoplasms were shown on MR images with non-mass enhancement, including 33 intraductal papilloma and 20 papillary carcinomas (9 intraductal papillary carcinoma, 6 solid papillary carcinomas, and 5 invasive papillary carcinoma). Mammography showed amorphous calcification in 20% (6/30), of which 4 were in papilloma and 2 were in papillary carcinoma. On MRI, papilloma mostly showed linear distribution in 54.55% (18/33), clumped enhancement in 36.36% (12/33). Papillary carcinoma showed segmental distribution in 50% (10/20), clustered ring enhancement in 75% (15/20). ANOVA showed age (p = 0.025), clinical symptoms (p < 0.001), apparent diffusion coefficient (ADC) value (p = 0.026), distribution pattern (p = 0.029) and internal enhancement pattern (p < 0.001) were statistically significant between benign and malignant of papillary neoplasms. Multivariate analysis of variance suggested that th...