MRI多参数分析在乳腺良、恶性病变诊断中的应用  

The Application of Breast Benign and Malignant Lesions Diagnosis with MRI Multiple Parametric Analysis

作　　者：王索宇[1] 徐仁根[1] 卢鸣剑[1] 刘岚[1] 孙美[1] 邹佳[1] 

机构地区：[1]江西省肿瘤医院放射科,南昌330029

出　　处：《南昌大学学报（医学版）》2010年第4期59-63,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨MRI多参数分析在乳腺良、恶性病变诊断中的应用。方法对44例乳腺疾病患者均行双乳T1WI、T2WI压脂扫描以及弥散加权成像(DWI)扫描。采用乳腺容积成像序列进行动态增强扫描。使用Functool软件进行表观弥散系数(ADC值)的测量、建立时间-信号强度增强曲线及计算出最大信号增加斜率(MSI)。结果 44例患者中,恶性25例,良性19例。其分叶及毛刺的敏感性、特异性、阳性预测值、阴性预测值以及准确度为62.5%～80.0%。时间-信号强度增强曲线显示:Ⅰ型曲线(平台型)17例,均为良性。Ⅲ型曲线(速升速降型)18例,均为恶性;其阳性预测值为100.0%,准确度为100.0%。Ⅱ型曲线(平台型或速升速降型)9例,其中良性2例,恶性7例。ADC值的敏感性为88.0%、特异性为84.2%、阳性预测值为88.0%、阴性预测值为84.2%、准确度为88.0%,各项指标均较高。MSI的敏感性为100.0%、特异性为100.0%、阳性预测值为100.0%、阴性预测值为90.5%、准确度为100.0%。结论乳腺疾病的MRI检查主要以形态学及动态增强后强化程度与方式评价为基础。时间-信号增强曲线、DWI及ADC值等对乳腺良、恶性病变的诊断有重要价值。Objective To explore the application of MRI multiple parametric analysis in diagnosis of breast benign and malignant lesions.Methods 44 cases patient of breast disease all received double-breast axial T1WI,T2WI series,axial fat-pressure series and axial diffusion weighted imaging（DWI） scan.Using volume imaging for breast assessment series proceed dynamic contrast-enhanced scan.Using Functool software to obtain the measurement of Apparent Diffusion Coefficient（ADC value）,time-signal strength curves as well as maximum slope to increase（MSI）.Results In all 44 cases,including 25 malignant,19 benign.The sub-leaf and burr of the breast lesions had 62.5% to 80.0% sensitivity,specificity,positive predictive value,negative predictive value and accuracy.Time-signal intensity curve area：Ⅰtype curve as a platform type,all 17 cases are benign,Ⅲ type curve as a ascensus and downhill speed type,18 cases in this group are all malignant,the positive predictive value is 100.0%,accuracy is 100.0%,Ⅱtype curve as a platform type or ascensus and downhill speed type,9 cases in this group with 2 benign and 7 malignant.ADC value with sensitivity of 88.0%、specificity of 84.2%、positive predictive value of 88.0%、negative predictive value of 84.2%,and accuracy of 88.0%,are all higher index.Maximum Slope to Increase（MSI） had sensitivity of 100.0%、specificity of 100.0%、positive predictive value of 100.0%、negative predictive value of 90.5% and accuracy of 100.0%.Conclusion MRI examination of the mammary gland disease mainly based on morphology and the evaluation of reinforcement level and style after dynamic enhancement.Time-signal enhancement curve,DWI and ADC values has important value in the diagnosis of breast benign and malignant lesions.

关 键 词：乳腺疾病 良性 恶性 MRI 多参数 

分 类 号：R814.2[医药卫生—影像医学与核医学]