关键词: 磁共振成像, BI-RADS分类, 乳腺病变, 弥散加权成像, 动态增强

Abstract: Objective To explore the application of multiparametric MRI in differentiating benign and malignant lesions classified as BI-RADS category 4 in breast imaging．Methods A total of 268 cases of breast MRI classified as BI-RADS category 4 with confirmed tumor pathology were retrospectively analyzed from January 2022 to December 2024 at the Tongji University Oriental Hospital Lujiang Branch．Among them,166 cases were categorized as benign lesions（including 93 cases of breast fibroadenoma,39 cases of intraductal papilloma,24 cases of cystic hyperplasia,2 cases of lobular tumor,and 8 cases of plasma cell mastitis）,while 102 cases were categorized as malignant lesions（including 89 cases of invasive ductal carcinoma,6 cases of invasive lobular carcinoma,2 cases of mucinous carcinoma,and 5 cases of inflammatory breast cancer）．The efficacy of single-sequence versus combined multiple-sequence imaging in diagnosing benign and malignant BI-RADS category 4 breast lesions was compared and analyzed．The diagnostic efficacy of the multiparametric MRI sequences was quantified by plotting a receiver operating characteristic curve and calculating the area under the curve（AUC）,as well as the specificity and sensitivity．Results The combined diagnostic efficacy of multiparametric MRI yielded the highest performance,with an AUC of 0.912（95%CI：0.871-0.953）,demonstrating a specificity of 0.922 and a sensitivity of 0.902．The optimal cutoff value for differentiating BI-RADS category 4 breast lesions based on apparent diffusion coefficient values was determined to be 0.84×10-3 mm2/s,with all results being statistically significant（P<0.05）．Conclusions Multiparametric MRI can effectively diagnose benign and malignant lesions classified as BI-RADS category 4,providing a reliable imaging basis for further diagnosis and treatment in breast surgery．

Key words: magnetic resonance imaging, BI-RADS category, breast lesions, diffusion weighted imaging, dynamic enhancement