MRI对乳腺非肿块样强化良恶性病变的鉴别诊断

MRI differential diagnosis of non-mass enhancement benign and malignant breast lesions

目的探讨MRI对乳腺非肿块样强化(NME)良恶性病变的诊断及鉴别诊断价值。方法回顾性分析96例乳腺NME病灶的MRI,参考2013年BI-RADS观察并比较良恶性病变间分布方式、内部强化特征、脂肪抑制T2WI信号、时间信号曲线(TIC)类型的差异,以多因素Logistic回归分析获得NME恶性病变的危险因素。结果96例患者中良性28例,恶性68例。单因素分析结果显示,在内部强化方式上,良恶性病变间表现为均匀强化的差异有统计学意义(P=0.026);在脂肪抑制T2WI信号上,良恶性病变间表现为高信号和等信号的差异有统计学意义(P=0.025、0.045);在TIC类型上,良恶性病变间表现为Ⅰ型和Ⅲ型的差异有统计学意义(P=0.013、0.001)。多因素Logistic回归分析,得到脂肪抑制T2WI等信号和TICⅢ型是恶性病变的危险因素,优势比分别为5.228和10.841。结论MRI征象对鉴别乳腺良恶性NME病变具有一定的价值。

Objective To investigate the value of MRI in diagnosis and differential diagnosis of benign and malignant non-mass enhancement(NME)breast lesions.Methods MRI data of 96 patients with breast NME lesions were retrospectively analyzed.MRI features,including distribution pattern,internal enhancement characteristics,signal intensity of T2WI with fat suppression and types of time-intensity curve(TIC)were compared between benign and malignant NME lesions.And Logistic analysis was used to obtain the risk factors for malignant lesions.Results There were 28 benign lesions and 68 malignant NME breast lesions.Statistically significant difference was found in the internal homogenous enhancement between benign and malignant lesions(P=0.026).As for the signal intensity of T2WI with fat suppression,there were significant differences in hyper and iso-signal intensity between benign and malignant lesions(P=0.025,0.045).As for the TIC types,the differences of typeⅠand typeⅢwere statistically significant between benign and malignant lesions(P=0.013,0.001).The risk factors of malignant lesions included iso-signal intensity of T2WI with fat suppression and typeⅢTIC,with the odds ratio(OR)of 5.228 and 10.841,respectively.Conclusion MRI has high diagnostic accuracy for breast cancer appeared as NME.