Contrast-enhanced MR angiography and BI-RADS for diagnosis of breast cancer

Objective:This study was to investigate whether combined vascularity score and BI-RADS can help differentiate malignant from benign breast lesions and therefore increase the additional sign of breast MRI.Methods:The study included 52 patients underwent dynamic breast MRI before biopsy.Contrast-enhanced MR angiography was scored on the maximum intensity projections(MIPS).The score ranged from 0(indicating absent or low breast vascularity) to 3(indicating high breast vascularity).MR images were evaluated and classified according to the MRI BI-RADS lexicon criteria.Level of suspicion was reported on a scale of I～V.Results:Final analysis of 52 lesions revealed 24(42.2%) malignant lesions and 28(57.8%) benign lesions.Significant differences were observed when the mean number of vessels per breast in the malignant cases was compared with per breast in benign cases(P=0.0000.05).If the breast vascularity score was that patients with a low vascularity score(category 0～1) as benign,and patients with a high vascularity score(category 2～3) as malignant,the sensitivity and specificity of breast MRI were 83.3% and 78.6%,respectively.Based on MRI BI-RADS lexicon criteria,the sensitivity and specificity were 87.5% and71.4%,respectively.After combined vascularity score and BI-RADS,the sensitivity and specificity were 83.3% and 85.7%.Conclusion:The presence of vessel seen on MR angiography represents a good marker for malignancy,and combined BI-RADS can help increase diagnostic specificity of breast MRI.