乳腺MRI动态增强对良恶性病变的鉴别价值

Efficacy of MRI Dynamic Enhanced Scan in Distinguishing Benign and Malignant Breast Lesions

目的:探讨磁共振动态增强技术(DCE-MRI)对乳腺良恶性病变的鉴别诊断价值。方法:18例乳腺良性病变、16例恶性肿瘤及2例交界性病变患者行DCE-MRI检查(平均年龄51.7岁)。对病变的边缘、形态、有无播散征、时间-信号曲线、最大增强斜率(MSI)、信号增强率(SER)和信号增强幅度(SEE)等7项指标进行了良恶性组比较。结果:除了MSI以外,其余6项指标在良恶性组之间差异均有显著性意义。用病变形态、时间-信号曲线及SEE等五项指标对36例乳腺病变综合评分结果显示:综合评分对诊断乳腺恶性肿瘤的灵敏度、特异度和准确性分别为93.8%、83.3%及88.2%。结论:结合DCE-MRI的病变形态学改变及动态增强表现对乳腺良恶性病变的鉴别有很好的诊断价值。

Objective： To discuss the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging （DCE MRI） in distinguishing malignant tumors of breast from benign lesions. Methods： A DCE MRI study was carried out in 18 benign lesions,16 malignant tumors and 2 borderline lesions of breast （mean age 51.7 years）. Seven items including shape, marginal feature, spreading signs, time signal intensity curve, maximum slope of increase （MSI）, signal enhancement ratio （SER） and signal enhanced extent （SEE） were compared between the patients with benign lesions and those with ma lignant tumors. Results： Shape,marginal feature, spreading signs, time-signal intensity curve, SEE and SER between the benign and malignant groups of breast showed significant difference except MSI. The 36 cases with breast lesions were given comprehensive scores by using 5 items including morphologic findings,time-signal intensity curve and SEE. The results displayed their sensitivity, specificity and accuracy for diagnosing malignant tumors of breast being 93. 8%, 83. 3% and 88.2% ,respectively. Conclusion：DCE MRI combined with morphology and dynamic enhanced features of breast lesion has good efficacy to differentiate malignant tumors from benign lesions.