乳腺肿瘤MRI动态增强模式研究

The features of breast tumor by dynamic enhanced magnetic resonance imaging

目的研究乳腺良恶性肿瘤的MRI动态增强模式特点。方法手术病理证实的乳腺肿瘤23例24个病灶,其中恶性13例14个病灶,良性10例10个病灶。采用PHILIPSinteraAchieva1.5T磁共振机行平扫和动态增强扫描加减影技术。分别用强化时间-信号曲线类型,1、2、4、8min强化率,峰值强化率,峰值强化时间来分析良恶性肿瘤的特点。结果动态增强减影显示全部病灶。恶性肿瘤的强化时间-信号曲线类型有A型7.1%(1/14)、B型78.6%(11/14)、C型14.3%(2/14);良性肿瘤有B型30.0%(3/10)、C型70.0%(7/10)。良恶性肿瘤的早期(1、2min)强化率的差异存在统计学意义(P<0.05)。而4、8min强化率和峰值强化率无统计学意义(P>0.05)。峰值强化时间在2min内100%为恶性;在2～4min间50.0%为恶性、50.0%为良性;>8min者20.0%为恶性、80.0%为良性。结论有效结合形态学和动态增强曲线类型、早期强化率和峰值强化时间可以提高乳腺良恶性肿瘤的诊断准确率。

Objective To investigate the features of breast benign or malignant tumor by dynamic enhanced MRI. Methods Thirteen patients with 14 breast cancer loci and 10 patients with 10 benign breast loci, which all diagnosed by pathology were recruited in the study. The patients underwent plain scanning and dynamic enhanced scanning combined with subtraction technique by 1.5T MRI of PHILIPS intera Achieva. The enhanced time-signal curve, the first, second, fourth and eighth minute enhanced rate, the peak enhanced rate and the peak enhanced time were used to analyze the features of benign or malignant tumor. Results Dynamic enhanced subtraction displayed all the loci. The enhanced time-signal curves of malignant tumor contained three groups： type A 7.1% （1/14）, type B 78.6% （11/14）,type C 14.3%（2/14）. And the enhanced time-signal curves of benign tumor contained two groups： type B 30.0% （3/10）, type C 70.0% （7/10）. There was significant difference in early enhanced rate （the first, second minute） between benign or malignant tumor （P〈0.05）; while there was no significant difference in enhanced rate and the peak enhanced rate at the fourth and the eighth minute （P〉0.05）. If the peak enhanced time was within 2 minutes all cases were malignant; if in 2 to 4 minutes, 50.0% cases were malignant tumor and 50.0% were benign tumor, if over 8 minutes 20.0% were malignant tumor and 80.0% were benign tumor. Conclusion Morphology combined with the dynamic enhanced curve, the early enhanced rate and the peak enhanced time of MRI can increase the diagnostic accurate rate of breast tumors.