Abstract
BACKGROUND: Due to the presence of distinctive morphological features and diverse pathological types, evaluation of breast non-mass enhancement (NME) lesions on magnetic resonance imaging (MRI) is challenging, generating more false-positive results as compared to enhancing mass lesions. Our objective was to identify the MRI features capable of distinguishing between benign and malignant NME lesions in the breast. METHODS: A retrospective analysis was conducted, in which the clinical data and MRI manifestations of 101 NME lesions were examined and confirmed through surgical or biopsy pathology. Statistical analyses, including t tests, Wilcoxon rank-sum tests, χ(2) tests, Fisher exact tests, and receiver operating characteristic (ROC) curve analyses, were employed to compare the MRI characteristics and clinical features of benign and malignant NME lesions. RESULTS: The study included 101 NME lesions from 98 patients (34 benign and 67 malignant). No statistically significant differences were observed in terms of clinical characteristics between the benign and malignant groups. However, there were significant differences in lesion maximum diameter (P=0.003), morphological distribution (P=0.003), internal enhancement patterns (P<0.001), time-intensity curve (TIC) types (P<0.001), early and delayed enhancement rates (P=0.001 and P<0.001, respectively), apparent diffusion coefficient (ADC), and T2 ratio (P=0.02). Notably, the diagnostic efficacy of ADC values was highest for the minimum value within a small region of interest (small ROI), yielding an area under the curve as high as 0.884. CONCLUSIONS: A comprehensive analysis of MRI features indicated their significant value for the differential diagnosis of benign and malignant NME lesions of the breast.