乳腺MR灌注时间-信号强度曲线表现及价值研究

The Study of MR Time-signal Intensity Curve in Breast Lesions

目的探讨乳腺MRT2*WI首次通过灌注时间-信号强度曲线(TIC)表现及其在乳腺病变鉴别诊断中的价值。资料与方法对40例乳腺肿瘤患者行乳腺动态增强成像扫描,绘制T2*WI首次通过灌注TIC及T1WI动态增强TIC。采用Fisher’s确切概率法检验,判定良、恶性病灶T1WI动态增强及灌注TIC的差异。结果良、恶性病灶灌注TIC之间差异具有显著性统计学意义(P<0.05=0.000);良、恶性病灶T1WI动态增强TIC之间差异有显著性统计学意义(P<0.05=0.011),但在平台型曲线类型中良恶性病灶有较大重叠。结论乳腺MR灌注TIC在良、恶性病灶具有显著差别,恶性病灶灌注TIC主要表现为信号快速下降后缓慢回升(A型)与快速下降后不回升(B型);良性病灶灌注TIC主要表现为平直型(C型)及缓慢上升后平台型(D型)。灌注TIC与病灶形态学结合可大大提高乳腺疾病诊断的准确性。

Objective To evaluate time-signal intensity curve （TIC） performance of breast MR T2WI first-pass perfusion imaging and its differential diagnostic value.Materials and Methods 40 cases with breast neoplasms verified by pathological results underwent T2-weighted first-pass perfusion MR imaging and TI-weighted dynamic contrast-enhanced imaging of the entire breast before surgery.The time signal intensity curves of the T2WI first-pass perfusion MR imaging and dynamic contrast-enhanced TI-weighted imaging were analyzed.The differences of the benign and malignant lesions in dynamic contrast-enhanced T1WI TIC and T2WI first-pass perfusion TIC were respectively detect by Fisher＇s exact test.Results There was a statistically significant difference in the time signal intensity curve of perfusion imaging between the benign and malignant breast lesions （P〈0.05 ,P=0.000）,and the time signal intensity curve of TI-weighted dynamic contrast-enhanced imaging between the benign and malignant breast lesions had a statistically significant difference （P0.05,P=0.011）,but there was a larger overlap between the malignant and benign lesions in plateau curve.Conclusion The combination of the time signal intensity curve of T2-weighted first-pass perfusion MR imaging and the morphology of the lesions on Tl-weighted dynamic contrast-enhanced MR imaging may greatly improve the diagnostic accuracy for breast lesions.