磁共振动态增强对乳腺良恶性疾病的诊断价值(附29例分析)

Clinical Application of Magnetic Resonance Dynamic Enhancement in the Diagnosis of Benign and Malignant Breast Diseases

目的:探讨磁共振动态增强对乳腺良恶性疾病的诊断价值及临床意义。方法:选取2012年8月至2016年4月因乳腺疾病于医院就诊的病人29例,采用我院Siemens Magnetom Avanto 1.5T超导型核磁共振仪器,行常规及增强扫描,并对增强病灶行形态学检查及血流动力学分析,比较磁共振动态增强在良恶性病变中的鉴别诊断价值。结果:29例患者(38枚)中,局灶性8枚,肿块性12枚,非肿块性18枚。乳腺良恶性病灶TIC曲线分布差异具有统计学意义,以Ⅱ、Ⅲ型曲线诊断恶性病变的敏感度为88.00%,特异性为61.54%;以Ⅲ曲线诊断恶性病变的敏感性为60.00%,特异性为84.61%。按照TIC的类型将良性病变分组,A组为Ⅰ型,B组为Ⅱ、Ⅲ型。两组TIC比较具有统计学差异(t=-6.44,P<0.001),良性病变A组与恶性病变组之间存在统计学差异(t=-6.43,P<0.001)。良恶性病变最大增强率均数比较无统计学意义(197.67%±72.54%vs 220.46%±76.12%;t=-0.89,P=0.380)。而两种病变的相对最大增强率均数比较具有统计学意义(1.12%±0.37%vs 2.42%±0.62%;t=-6.92,P<0.001)。良恶性病变患侧乳腺血管计数评分均数比较具有统计学差异(1.02±0.53 vs 2.94±0.68;t=-8.86,P<0.001)。结论:磁共振动态增强可充分显示病灶的形态学特征,比较TIC曲线、病灶强化程度及病灶局部血管成像分析,对区分乳腺良恶性病变及相应的治疗方案具有重要意义。

Objective:To investigate the diagnostic value and clinical significance of magnetic resonance dynamic enhancement in benign and malignant breast diseases.Methods:From August 2012 to April 2016,29 patients were treated with breast disease in our hospital.The Siemens Magnetom 1.5 Tsuperconducting nuclear magnetic resonance instrument was used to perform routine and enhanced scanning.To enhance the morphological examination and hemodynamic analysis of the lesion,and to compare the diagnostic value of magnetic resonance dynamic enhancement in benign and malignant lesions.Results:Of the 29 patients,8 were focal,12 were swollen and 18 were non-The difference of TIC curve between benign and malignant breast lesions was statistically significant.The sensitivity of diagnosis of malignant lesions was88.00% and the specificity was 61.54% with Ⅱ andⅢ curves.The sensitivity ofⅢ curve was 60.00% Was 84.61%.According to the type of TIC will benign lesions group,A group for the typeⅠ,B group for theⅡ,Ⅲtype.There was a statistically significant difference between the two groups(t=-6.44,P<0.001),and there was a significant difference between benign lesion group A and malignant lesion group(t=-6.43,P<0.001).The maximal rate of enhancement of benign and malignant lesions was not statistically significant:(197.67±72.54)% vs(220.46±76.12)%,t=-0.89,P=0.380;(1.12±0.37)% vs(2.42±0.62)%;t=-6.92,P<0.001,and the mean maximal enhancement rate of the two lesions was statistically significant.The mean number of ipsilateral breast vascular count scores was statistically different:(1.02±0.53)vs 2.94±0.68,t=-8.86,P<0.001.Conclusion:Magnetic resonance dynamic enhancement can fully show the morphological features of the lesion.Comparison of TIC curve,lesion enhancement and localized angiographic analysis of lesions,the distinction between benign and malignant breast lesions and the corresponding treatment program is of great significance.