3．0T磁共振动态增强在乳腺浸润性导管癌诊断中的应用价值  

Applied Value of MR Dynamic Contrast--Enhancement at 3.0T MR Magneton in Diagnosing Infiltrating Ductal Carcinoma of Breast

作　　者：刘润[1] 龚洪翰[1] 曾献军[1] 裴莉[1] 彭德昌[1] 周俊杰[2] 

机构地区：[1]南昌大学第一附属医院影像科,江西南昌330006 [2]湖南省长沙市中心医院影像科

出　　处：《实用放射学杂志》2010年第4期556-560,共5页Journal of Practical Radiology

摘　　要：目的探讨MR动态增强在乳腺浸润性导管癌诊断与鉴别诊断中的应用价值。方法17例乳腺浸润性导管癌，均采用3．0TMR扫描仪及乳腺专用线圈行常规MR平扫和动态增强检查。所有病例均经手术病理证实，分析比较病灶的MRI信号强度、形态学以及血流动力学特点。结果17例17个乳腺浸润性导管癌均表现为肿块型，T1WI呈低信号影（8／17）或等信号影（9／17），T2WI呈高信号影（14／17）或等信号影（3／17）。形态学表现：病灶不规则形及分叶状占82．4％（14／17）；病灶边界不清楚（12／17）、边缘不光滑（15／17），其中毛刺征或星芒征7例。病灶增强后多表现为不均匀性显著强化（10／17）或环形强化（5／17）；在最大信号强度投影（MIP）图上有82．4％（14／17）的病灶周围可见血管纠集征。血流动力学表现为所有病例早期强化率均〉90％；88．2％（15／17）的病灶强化峰值〈3min；时间-信号强度曲线以Ⅱ、Ⅲ型为主，Ⅱ型36．3％（6／17），Ⅲ型58．8％（10／17）。结论乳腺浸润性导管癌MR动态增强影像学表现具有一定的特征性，有助于本疾病的诊断与鉴别诊断。Objective To explore the value of MR dynamic contrast--enhancement in diagnosis and differential diagnosis of infiltrating ductal carcinoma of breast at 3.0T MR magneton. Methods 17 cases of breast infiltrating ductal carcinoma underwent plain MRI and MR dynamic contrast--enhanced scan using 3.0T MR scanners with dedicated breast coil. All cases were confirmed by surgery and pathology. MRI signal intensity, morphology and hemodynamie characteristics of lesions were analysed. Results 17 breast infiltrating duetal carcinomas in 17 cases all appeared as masses, low（8/17）or equal（ 9/17）signal intensity on T1WI, high（ 14/17） or equal（3/17） signal intensity on T2 WI. On morphology, the lesions were irregular and lobulated in shape（82.4 % , 14/17） ;undefinite margins（ 12/17）or non-- smooth margins （15/17 ）, glitch sign or astral sign （ 7/17 ） ; the lesions showed non -- uniform marked enhancement （10/17）or ring enhancement（5/17） after intravenous administration of contrast agent. 82.4 %（14/17） of the lesions, the blood vessels could be seen gathering around the lesions on the maximum intensity projection （MIP） image. On hemodynamies,the early enhanced ratio for all cases was over 90% ;88.2%（15/17） of the lesions, peak enhancement was less than three minutes; the time--signal intensity curve of the lesions appeared as type Ⅱ was 35.3 %（6/17 ）and type Ⅲ was 58.8%（10/17） mostly. Conclusion Dynamic contrast--enhanced MRI manifestations of breast infiltrating ductal carcinoma are of certain characteristics,which may contribute to the diagnosis and differential diagnosis.

关 键 词：乳腺 浸润性导管癌 磁共振成像 动态增强 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]