动态增强MRI鉴别乳腺良恶性病变的价值  

The Dynamic-Contrast MRI Manifestation of Breast Lesions

作　　者：汪晓红[1] 耿道颖[1] 顾雅佳[1] 彭卫军[1] 杨天锡[1] 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科,上海200032

出　　处：《放射学实践》2005年第8期662-666,共5页Radiologic Practice

摘　　要：目的:探讨动态增强MRI对乳腺良恶性病变的鉴别诊断价值。方法:对147例经手术病理证实的乳腺疾病患者行MRI平扫和动态增强检查。分析比较乳腺良恶性病变的MRI征象,包括形态学、内部信号及其动态增强特征等,计算病灶峰值增强率Emax,峰值时间Tmax,最大强化速率Slopemax,并根据病变最高强化区ROI测量值,绘制病灶的时间信号强度曲线。结果:147例患者共计病灶152个,其中恶性87个,良性65个。分析比较病变的形态学及动态增强表现,发现乳腺良性病变多呈类圆形或分叶状,边缘光整,无毛刺、边界多清晰,强化均匀或伴有内部分隔等,动态强化参数Emax多大于90%,Tmax多大于240s,Slopemax多大于3%/s;恶性病变则多为不规则形,边缘可伴毛刺,与周围结构分界不清,强化不均匀,病灶常呈环形强化,导管样强化,Emax多大于90%,Tmax多大于240s,而Slopemax多大于3%/s。时间信号曲线类型恶性病变多表现为Ⅱ或Ⅲ型,良性病变则多为Ⅰ或Ⅳ型。结论:乳腺MRI不仅提供了病灶丰富的形态学信息,而且还通过动态增强进一步揭示病变的血流动力学特征,从而有助于对乳腺病变作出准确的定性诊断,更有效地鉴别诊断乳腺良恶性病变。Objective：To investigate the value of contrasted MRI on diagnosis of breast lesions. Methods： 147 patients were enrolled in this study who were confirmed as breast lesions verified by surgery and histopathology. All the lesions were evaluated by plain and contrasted MR]. The lesion detectability of T1 WI,T2 WI,and contrasted series, the signal intensity character,enhancement pattern.morphology manifestation of the lesions were observed. Results： 147 patients had 87 malignant and 65 benign lesions, There were significant difference between benign and malignant tumors on enhancement homogenity,morphology and margin characteristics （P〈0.05）, According to the morphology character and enhancement pattern, the rate of sensitivity, specifity and accuracy were 95. 5%, 83. 9% ,90. 2%, Conclusion： Enhanced MRI is better than plain exam on lesion detection, Benign and malignant breast tumors can be differentiated according to the morphology characteristic and enhancement pattern.

关 键 词：乳腺肿瘤 磁共振成像 乳腺X线摄影术 MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学]