MRI动态增强技术对小乳腺癌的诊断价值

Preliminary application of dymaic-contrast MRI in diagnosis of small breast cancer

目的:研究小乳腺癌在磁共振成像(MRI)动态增强扫描图像上的影像表现及其动态增强扫描时间—信号曲线的特征,评价MRI动态增强扫描技术在小乳腺癌诊断中的临床应用价值。方法:将39例钼靶不能明确诊断的女性患者纳入研究(病理证实病灶≤2 cm)并行双侧乳腺动态高分辨对比增强MRI。利用MRI工作站功能软件描绘时间—信号强度曲线(TIC)。结果:39例患者中19例为乳腺癌,20例为良性乳腺肿瘤。19例小乳腺癌SI-Time曲线中15例呈I型,3例呈II型,1例呈III型,早期增强率11例≥60%。20例良性肿瘤TIC曲线中2例呈I型,2例呈II型,16例呈III型,早期增强率5例≥60%。将恶性病变形态特征、早期增强率≥60%、I型TIC曲线作为联合诊断标准,其中符合两项为确诊,诊断灵敏度为92%、特异度为90%、准确率为95%。结论:乳腺肿块的MRI形态学特征结合TIC曲线及早期强化率联合诊断提高了乳腺小肿块的定性诊断特异性及敏感性,可为小乳腺癌的诊断和鉴别提供重要的信息。

Objective： To study the imaging features and time- signal intensity curve of small breast lesions, and to evaluate the value of clinical application of dynamic contrast- enhanced MRI scan technique in diagnosis of small breast cancers. Methods： Thirty nine female patients pathologically confirmed small breast lesions（〈2 cm）underwent bilateral breast dynamic contrast enhanced MRI. Use MRI workstation function software to describe the time- signal intensity curve（TIC）. Results： 19 cases were pathologically confirmed as small breast cancer, 20 cases were benign breast tumor. 15 cases of small breast cancer showed TIC typeI, 3 cases showed type lI, 1 cases showed type III.Eleven among 19 cases of early enhancement rate _〉60%. Two among 20 cases of benign tumor TIC curve showed type I, 2 cases showed type II, 16 cases showedtype III, 5 cases of benign tulnor early enhancement rate _〉 60%. The morphological characteristics, early enhanced rate 〉_60%, TIC type I as the diagnostic criteria.The combination of two types of information in the presented diagnostic algorithm achieved an optimized sensitivity of 92%, specificity of 90%, accuracy of 95%. Conclusion： MRI features of breast lesions in combination with the TIC and the early phase enhancement rate improves breast small tumor diagnosis sensitivity and specificity, which can provide valuable information in diagnosis of small breast cancer.