MRI三维动态增强减影技术鉴别乳腺良恶性病变的研究

Differential Diagnosis of Breast Benign and Malignant Lesions with Three Dimensional Dynamic Contrast and Digital Subtraction MR Imaging

目的探讨磁共振三维动态增强减影技术在乳腺癌诊断中的应用价值。方法52例乳腺病变磁共振检查分别进行反转恢复法加权成像、动态增强扫描、减影成像,评价乳腺良恶性病变的MRI征象、早期增强率、峰值增强率、峰值时间、时间-信号强度(T-SI)曲线等指标的诊断价值。结果乳腺癌的形态学特征性表现有形态不规则、环形强化和毛刺征;乳腺良性病变特征性表现有类圆形或分叶状,边缘光整,强化均匀及强化后可见低信号间隔。良恶性病变的早期增强率、达到峰值强化的时间以及曲线类型分布之间有显著性差异(P<0.05),峰值增强率无显著性意义。结论MRI三维动态增强减影技术能满意显示乳腺良恶性病变的形态学特征和增强的血液动力学特点,是诊断乳腺癌十分有用的检查方法。

Objective To study the value of three dimensional dynamic contrast and digital subtraction MRI in diagnosing breast cancer. Methods 52 patients with breast diseases were enrolled in this study,including 27 malignant lesions and 36 benign lesions verified by histopathology. The morphologic features and enhancement kinetics of breast lesion on MRI were observed. The morphologic manifestation, ear- ly-phase enhancement rate,peak enhancement rate,peak time and time-signal intensity curve were evaluated. Results The benign lesion were mainly characterized by regular mass,well-defined border,internal septation,homogeneous enhancement,and the malignant lesions bir- regular shape, speculated margin, rim enhancement, inhomogeneous enhancement. The early-phase enhancement rate, peak time and curve type were significantly different between breast benign and malignant lesions（P 〈 0.05）, but the peak enhancement rate was no significant differ- ence. Conclusion The early-phase enhancement rates, peak time and time-signal intensity curve pattern are very useful in diagnosing breast cancer,but there is an overlapping in some patients.