3.0T磁共振在乳腺检查中的初步应用

Preliminary Study of the Feasibility on Breast Examination Using Super High-magnetic Field-strength 3.0T MR Scan

目的:探讨3.0T磁共振利用体部相控阵线圈进行乳腺检查的临床应用价值。方法:36例乳腺疾病患者中隆乳术后26例,乳腺癌6例,乳腺良性病变4例,均行常规MRT1WI、T2WI和压脂序列T2WI,17例行动态增强扫描,13例行扩散加权成像,并与术后病理结果进行对照分析。结果:36例乳腺疾病患者均能显示显示乳腺结构及邻近组织情况,图像清晰无变形。22例聚丙烯酰胺水凝胶注射隆乳术后患者,注入物于T1WI呈稍低信号、T2WI呈高信号,在脂肪抑制T2WI上显示最清晰,呈均匀高信号;4例角鲨烯注射液隆胸术后,注入物在T1WI和T2WI上呈小颗粒状脂肪信号影。6例乳腺癌于DWI上呈明显高信号,动态增强曲线呈早期信号快速上升,中晚期信号强度逐渐降低表现;4例发现腋窝淋巴结转移。4例乳腺良性病变,动态增强曲线呈逐渐上升改变。结论:3.0T磁共振结合体部相控阵线圈可显示隆胸材料的性质和分布,常规MRI扫描结合DWI和动态增强扫描对乳腺良恶性病变的鉴别诊断有重要临床价值。

Objective： To study the clinical application of breast examination using body-coil on 3.0T MR scan. Methods：36 cases with breast lesion, including augmentation mammaplasty （n ： 26）, breast cancer （n ： 6） and benign breast lesion （n=4） were studied with 3.0T MR scan. All of these patients had routine TlWI,T2WI as well as fat-sup- pressed T2WI sequences,contrast enhanced MRI were performed in 17 patients and diffuse weighted imaging （DWI） in 13 patients. Their MRI features were retrospectively analyzed and correlated with pathology findings. Results：The structure of breast were shown clearly without distortion in all of these patients. Polyacrylamide jel materials were-injected into the breast in 26 cases for mammoplasty showed hypo-intensity on T, WI and hyper-intensity on T2WI, which was clearly displayed on fat-suppressed T2WI. Injected squalene materials for mammoplasty showed small particles with fat-like intensities on both T, WI and T2 WI. 6 cases with breast cancer showed marked hyper-intensity on DWI, the signal intensities increased markedly in early phase after dynamic contrast enhancement, and gradually decreased in the mid and late phases. Axillary lymph lnode metastasis were revealed in 4 patients. However, in 4 cases having benign breast lesions,gradually increased intensities were assessed after dynamic contrast enhancement. Conclusion：Augmentation mammaplasty materials and their distribution might be displayed by using super high-magnetic-field-strength 3.0T MR scan in combination with body-coil. Routine MRI sequences combined with DWI and dynamic contrast enhancement provided helpful information in the differential diagnosis of benign and malignant breast lesions.