摘要
目的 探讨VIBRANT多时相增强MRI鉴别乳腺良、恶性病变的临床价值。方法 采用GE1.5T MR仪及4通道乳腺相控阵线圈，对53例（57灶）患者双侧乳腺平扫后用Gd-DTPA（磁显葡胺0.1mmol/kg）以2.0ml/s静脉团注，注药后约15秒开始第1次采集，采集时间约57秒，连续无间隔采集8-10次。结果 除1例外，所有乳腺脂肪抑制均匀。乳腺病变形态是否规则及边缘是否有毛刺与病变良、恶性关系显着（P〈0.05）。边缘毛刺征特异度95%（19/20）。恶性病变1分钟早期增强率高于良性病变（P〈0.05），诊断灵敏度及特异度分别为91.89%及65%。恶性病变时间-信号强度曲线Ⅰ型（单相型）10.81%（4/37），Ⅱ型（平台型）2.7%（1/37），Ⅲ型（流出型）86.49%（32/37）;良性病变Ⅰ型65%（13/20），Ⅱ型5%（1/20），Ⅲ型10%（2/20），Ⅳ型（环状或无明显强化）20%（4/20）。以Ⅱ型或Ⅲ型为恶性标准，诊断灵敏度、特异度分别为89.19%及85%。形态学与血流动力学相结合，灵敏度、特异度及准确率分别为91.89%（34/37），85%（17/20），89.47%（51/57）。结论 应用VIBRANT进行乳腺多时相增强MRI脂肪抑制较好，可以得到较好的形态学和血流动力学信息。时间-信号强度曲线是鉴别乳腺良、恶性病变比较有效的方法。1分钟早期增强率诊断灵敏度较高，边缘毛刺征特异度较高。形态学与血流动力学相结合，可以提高诊断准确率。
Objective To evaluate the clinical value of multiphase contrast-enhanced MRI with VIBRANT for the diagnosis of breast lesions. Methods Fifty-three female patients with histologically proven malignant （36 cases with 37 lesions） and benign （17 cases with 20 lesions） lesions in the breast were performed bilateral breast axial or sagittal multiphase contrastenhanced MRI with VIBRANT by 4-channal phased-assay breast coil at 1.5T （GE）. Acquisition time of every phase about 57 seconds and 8-10 phases repeat acquisition with no intervals after Gd-DTPA （2.0 ml/s, 0.1 mmol/kg） administration. Results All breasts, except for 1 case, had good fat saturation. There were significant differences between the malignant and benign lesions at morphology （P〈0. 05） and margin （P〈0.05） characteristics, the diagnostic specificity of spinous margin for malignant lesions was 95 % （19/20）. The mean enhancement rate of the malignant lesions at 1 minute after GdDTPA administration was higher than that of the benign lesions （P〈0.05） with sensitivity and specificity being 91.89 %, 65%. The type Ⅰ （monophasic） of time-signal intensity curves for malignant lesions was 10.81% （4/37）, type Ⅱ （biphasic） was 2.7% （1/37）, and typeⅢ （washout） was 86. 49% （32/37）. The type Ⅰ for benign lesions was 65% （13/20）, type Ⅱ was 5% （1/20）, type Ⅲ was 10% （2/20）, and type Ⅳ was 20% （4/20）. The diagnostic sensitivity and specificity was 89.19 % and 85 %. The combination of morphologic and kinetic characteristics had a sensitivity, specificity and accuracy of 91.89%（34/37）, 85%（17/20）, 89.47%（51/57）. Conclusion Multiphase contrast-enhanced MRI with VIBRANT can be acquired better information about morphologic and kinetic characteristics of breast lesions with better fat saturation. The time-signal intensity curve is useful in differentiating malignant lesions from benign ones. Enhancement rate at one minute has better sensitivity while spinous margin has better
出处
《中国医学影像技术》
CSCD
北大核心
2007年第5期678-682,共5页
Chinese Journal of Medical Imaging Technology
基金
全军"十一五"计划资助项目(06MA245)
关键词
乳腺肿瘤
对比增强
磁共振成像
Breast neoplasms
Contrast-enhanced
Magnetic resonance imaging
