Morphological Assessment of Breast Lesions With Type 2 Dynamic Curves Using DWI and T2WI Based on Breast Imaging Reporting and Data System Lexicon Descriptors

Purpose: This study aimed to qualitatively assess the added diagnostic value of diffusion‐weighted imaging (DWI) and T2‐weighted imaging (T2WI), using Breast Imaging Reporting and Data System (BI‐RADS) lexicon descriptors, in evaluating breast lesions with type 2 dynamic curves. Materials and Methods: We retrospectively reviewed 181 breast lesions with type 2 dynamic curves in 181 consecutive patients who underwent 3‐Tesla (3‐T) magnetic resonance imaging (MRI). Trained radiologists assessed the morphological features of the lesions on dynamic contrast‐enhanced (DCE) MRI, DWI, and T2WI using BI‐RADS lexicon descriptors and measured the apparent diffusion coefficient (ADC). Statistical analysis was performed to compare variables in lesion type groups (mass‐like group vs. nonmass‐like group). Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC) and the DeLong test, with statistical significance at p < 0.05. Results: In mass‐like lesions, all morphological parameters significantly distinguished benign from malignant lesions on DCE, DWI, and T2WI (all p < 0.05). ADC values also showed significant differences ( p < 0.05). The combined approach (DCE + DWI + T2WI) yielded the highest AUC (0.895), significantly outperforming the individual methods (all p < 0.05). In nonmass‐like lesions, no parameter significantly predicted malignancy (all p > 0.05). Conclusion: The addition of DWI and T2WI, interpreted using the BI‐RADS lexicon descriptors, enhances the differential diagnosis of breast lesions with type 2 dynamic curves.