摘要
目的探讨并评价MRI乳腺动态增强扫描在乳腺良恶性病变中的诊断价值。方法回顾性分析经手术病理或临床随访证实的82例乳腺病变患者,采用PHILIPS Achieva 1.5T和Siemens 3.0T磁共振扫描仪先行常规及扩散加权成像扫描,之后行乳腺动态增强扫描,对增强病变进行形态学及血流动力学分析,比较其在良恶性病变中的鉴别诊断价值。结果 88个异常强化病灶中,局灶性6个,肿块性30个,非肿块性52个。乳腺良、恶性病变的动态增强曲线分布差异有统计学意义（χ^2=16.35,P〈0.001）。以Ⅱ、Ⅲ型曲线诊断恶性病变敏感度为82%（41/50）,特异性为57.89%（22/38）,准确性为71.59%（63/88）。把良性病变的早期增强率按照TIC类型分成2组,Ⅰ型为A组,Ⅱ、Ⅲ型为B组,2组间均数分别为（55.3±20.5）%、（189.3±58.2）%,2组间差别具有统计学意义（t=9.832,P〈0.001）。相应恶性病变均数为（206.7±66.4）%,良性病变A组与恶性病变差别有统计学意义（t=12.508,P〈0.001）。良、恶性病变最大增强率均数分别为（199.3±70.5）%、（224.3±78.6）%,2组间差别无统计学意义（t=0.307,P=0.384）。而良、恶性病变相对最大增强率分别为（1.084±0.350）%/s、（2.316±0.53）%/s,2组间差别具有统计学意义（t=8.356,P=0.003）。良恶性病变患侧乳腺血管计数得分均数分别为1.06±0.42、2.89±0.57,差别具有统计学意义（t=6.37,P〈0.01）。结论动态增强MRI可充分显示异常强化病灶的形态学特征,不同强化病灶形态与其病理基础有一定相关性;乳腺动态增强时间信号强度Ⅰ型曲线与乳腺良性病变、Ⅱ-Ⅲ型曲线与乳腺恶性病变有明显相关性;相对最大增强率在乳腺良恶性病变鉴别诊断中的价值明显优于早期增强率及最大增强率;病变侧乳腺血管数量及扩张程度可作为乳腺良恶性病变鉴别诊断指标之一。
Objective To investigate and evaluate the diagnosis value of dynamic contrast-enhanced MRI（ DCE-MRI） in differentiation of benign and malignant breast lesions. Methods The data of 82 cases of breast lesions confirmed by surgery,histopathologic examination or clinical follow-up were reviewed. Routine and DWI scan followed by dynamic contrastenhanced imaging was done using PHILIPS Achieva 1. 5T and Siemens Verio 3. 0T. The morphological features and hemodynamic parameters of breast enhancing lesions were studied to evaluate the diagnosis value of DCE-MRI in differentiating benign and malignant breast lesions. Results Total 88 abnormal enhancing lesions included 6 focal,30 mass and 52 nonmass enhancements. The distribution of TIC types had statistic significances between benign and malignant lesions（ χ^2=16. 35,P〈0. 001）. The sensitivity,specificity and accuracy of TIC type Ⅱ and Ⅲ was 82%（ 41 /50）,57. 89%（ 22 /38）and 71. 59%（ 63 /88）,respectively. The early-phase enhancement rate of benign lesions were divided into two groups according to the TIC： typeⅠ was group A,and type Ⅱ and Ⅲ were group B,the mean of the two groups was（ 55. 3 ±20. 5） % and（ 189. 3 ± 58. 2） %,respectively,there was statistic significances between A and B（ t = 9. 832,P〈0. 001）.The corresponding mean of malignant lesions was（ 206. 7 ± 66. 4） %,there was statistic significances between benign and malignant lesions in group A（ t = 12. 508,P〈0. 001）. The mean peak enhancement rate of benign and malignant lesions was（ 199. 3 ± 70. 5） % and（ 224. 3 ± 78. 6） %,respectively,t = 0. 307,P = 0. 384. The mean of relative peak enhancement rate of benign and malignant lesions was（ 1. 084 ± 0. 350） % /s and（ 2. 316 ± 0. 530） % /s,respectively,t = 8. 356,P = 0. 003. The score of ipsilateral breast vessels of benign and malignant lesions was 1. 06 ± 0. 42 and 2. 89 ± 0. 57,respectively,t = 6. 37,P〈0. 01. Conclusion Dynamic contrast-enhanced MRI can fully display morphological
出处
《中华全科医学》
2014年第9期1449-1451,1453,F0003,共5页
Chinese Journal of General Practice
关键词
磁共振
动态增强扫描
乳腺病变
Magnetic resonance imaging
Dynamic contrast-enhanced MRI
Breast lesions
