多层螺旋CT动态增强扫描对乳腺疾病诊断的价值  

Diagnostic value of the enhanced dynamic multi-slice helical CT scanning in breast diseases

作　　者：赵艳萍[1] 文智[1] 阿里甫.依马木 努尔兰.吐尔逊 马继文[1] 贾志强[1] 佟灵力[1] 

机构地区：[1]新疆医科大学附属肿瘤医院CT室,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2009年第1期68-71,共4页Journal of Xinjiang Medical University

摘　　要：目的:了解多层螺旋CT动态增强扫描对乳腺良恶性病变诊断的价值。方法:42例45个病灶,其中乳腺癌病灶22个,乳腺良性病变23个(乳腺炎9个,乳腺纤维瘤4个,乳腺增生性疾病10个),行多层螺旋CT扫描平扫,并于增强后60、120、180、300、480 s进行多期增强扫描。结果:(1)CT表现:乳腺癌多为不规则肿块,伴分叶、毛刺及周围浸润的表现;明显不均匀强化。乳腺炎为乳腺密度增高,边缘模糊,多无明确肿块,伴有邻近皮肤增厚,皮下脂肪层混浊,多明显强化。乳腺纤维瘤为等密度、边界清、轮廓光整肿块,均匀强化。乳腺增生性疾病呈腺体增厚,增强为多发或弥漫性分布的强化灶,强化弱且不均匀。(2)时间密度曲线(TDC):乳腺癌和乳腺炎呈速进速退型,乳腺纤维腺瘤表现为持续上升型,乳腺增生性疾病表现为缓慢上升型。(3)各组病灶平扫CT值差异无统计学意义,增强后延迟60 s和120 s时乳腺增生组CT值增强幅度△CT值与乳腺炎和乳腺癌的△CT值差别有统计学意义(P<0.05);延迟180、300、480 s时纤维腺瘤的△CT值与乳腺炎、乳腺癌和乳腺增生组的△CT值差别有统计学意义(P<0.05)。结论:多层螺旋CT动态增强扫描对乳腺疾病具有重要的诊断和鉴别价值。Objective： To study the diagnostic Methods： Forty five lesions in 42 patients, value of the enhanced dynamic CT scanning in breast diseases. including 22 lesions of breast cancer and 23 benign breast lesions, were examined by multi-slice helical CT with plain scan and multiphase enhanced scan. Results： （1） The CT appearance of breast cancer： spiculated, irregular or lobulated mass and invasive sign, which could be significant and uneven enhance. The mastitis manifested with thickening mammary gland, no obvious boundary, thickening skin and increased density of peripheral fat tissue. Breast fibroadenoma displayed with isodensity, regular boundary mass and homogeneously enhance. Benign hyperplasia appeared with symmetrical thickening of breast gland, could be enhanced slightly. （2） The time density curve （TDC） of breast cancer and mastitis were similar with rapid rise and rapid decline. The TDC of fibroadenoma went on dramatically. The benign mammary hyperplasia showed a gradually increasing curve. （3） The difference of CT value in plain scan of four kinds of breast diseases had no statistics significance. There were statistic differences between enhancement extent （△CT value） of benign breast hyperplasia in delayed 60s and 120 s scanning with that of breast cancer and mastitis and that of fibroadenoma in delayed 180 s, 300 s and 480 s with that of breast cancer and mastitis （P 〈0.05）. Conclusion： CT dynamic scanning has considerable value in diagnosis and differential diagnosis in breast diseases.

关 键 词：动态增强 体层摄影术 X线计算机 乳腺疾病 

分 类 号：R814.42[医药卫生—影像医学与核医学] R655.8[医药卫生—放射医学]