MR动态增强联合扩散加权成像技术在乳腺疾病诊断中的价值

Dynamic contrast-enhanced MR combined with diffusion-weighted imaging in diagnosis of breast lesions

目的探讨乳腺MR动态增强扫描联合扩散加权威像技术在乳腺疾病影像诊断中的价值。方法对48例女性乳腺患者进行MRI检查，先进行双侧乳腺常规MRI平扫，再进行双侧乳腺扩散加权平面回波（EPI）序列扫描，最后行乳腺动态增强扫描。通过后处理，得到病灶处表观弥散系数（ADC）值及时间-信号强度曲线。结果根据时间-信号强度曲线特点及ADC值，结合常规MRI形态学特点进行良、恶性病变诊断。MRI诊断为恶性肿瘤19例．良性病变29例。手术或活检病理结果证实MRI诊断为恶性肿瘤的19例患者中。18例为恶性肿瘤，另外1例为良性肿瘤（旺炽性腺瘤）；MRI诊断为良性病变的29例患者，手术或病理活检均证实为良性病变。MRI区分乳腺良、恶性病变的准确率为97．9％（47／48），与手术或病理活检准确率（100％）比较差异无统计学意义（x^2=0．044，P：0．834）。结论动态增强扫描联合扩散加权成像技术，可提高乳腺疾病影像诊断准确率。

Objective To evaluate the application of dynamic contrast enhanced magnetic resonance imaging （MRI） combined with diffusion weighted imaging （DWI） in diagnosis of breast lesions. Methods Breast MR scan was performed in 48 female patients with breast lesions. Conventional MR bilateral mammary scan was performed first, followed by DWI and echo pla- nar imaging （EPI） sequential scan; finally dynamic contrast enhanced MR scan was completed. The apparent diffusion coefficient （ADC） value and time-signar curve on the location of breast lesions were obtained with post-processing technique. Results Benign and malignant breast lesions were defined according to ADC value and time-signal curve, as well as conventional MRI findings. There were 19 patients with malignant and 29 with benign breast lesions based on MRI diagnosis. Among 19 patients with MRI malignant diagnosis, 18 were confirmed pathologically, and remaining 1 patient was benign lesion （florid adenoma）; all 29 patients with MRI benign diagnosis were confirmed pathologically after surgery or biopsy. Compared to pathological examina- tion of surgery or biopsy, the accuracy rate of MRI diagnosis on breast lesions was 97.9% （47/48）. Conclusion Dynamic con- trast-enhanced MRI combined with diffusion-weighted imaging provides a satisfactory differential diagnosis between benign and malignant breast lesions.