健康人停经前乳腺动态增强MRI表现

Healthy Premenopausal Breast Parenchyma in Dynamic Contrast-Enhanced MR Imaging of the Breast

目的 :评价健康人停经前乳腺动态增强MRI表现 ,探讨其鉴别健康人停经前乳腺实质内出现的增强灶和良恶性病变的能力。材料和方法 :对 18例健康自愿者和 40例乳腺病变患者行 3D动态增强MRI检查。分析实质增强灶数量、形态、早期增强率和时间 信号强度曲线形态并与良恶性病变比较。结果 :5 5 6%的自愿者乳腺内出现实质增强灶。其表现为片状或结节状 ,边缘模糊、不规则或光滑 ,早期增强率小于良恶性病变 ,与腺体无明显差异 ,时间 信号强度曲线均为单相型 ,明显不同于恶性病变。结论 :停经前妇女乳腺内出现对比增强灶是一种正常表现 ,时间 信号强度曲线是鉴别实质增强灶与恶性病变的很好方法。

Purpose: To evaluate normal contrast enhancement patterns in healthy, premenopausal breast parenchyma, and to estimate the diagnostic ability of the morphology, early phase enhancement rate, and signal intensity time course in differentiating normal enhanced parenchyma from benign and malignant breast lesions. Materials and Methods: 18 healthy premenopausal volunteers and 40 cases with pathologically identified breast lesions were examined with a new efgre 3D dynamic MR imaging series. Morphology, early phase enhancement rate, and signal intensity time course of the contrast enhancing areas in volunteers were investigated and compared with that of benign and malignant lesions. Results: 13 contrast enhancing areas were detected in 10 of the 18 volunteers. They showed either an ill defined shape with irregular margins or a well circumscribed configuration with irregular or smooth margins. The early phase enhancement rate of the contrast enhancing areas in volunteers was lower than that of benign and malignant lesions (p<0.05). Only monophasic time signal intensity curves were found in the contrast enhancing areas. The distribution of curve types of the contrast enhancing areas were significantly different from that of malignant lesions (p<0.001). Conclusion: Contrast enhancing foci are normal in healthy premenopausal breasts. A monophasic time signal intensity curve is a strong indicator of benign and can be used to distinguish the normal enhanced parenchyma from malignant lesions.