探讨血供在鉴别乳腺良恶性病变中的价值  

The Value of Ipsilaterally Increased Vascularity in Differentiating Benign and Malignant Breast Lesions

作　　者：王海丽[1] 刘鹏程[1] 韦伟[2] 冯飞[1] 刘汉桥[1] 方玲[1] 邹立秋[1] 黄嵘[1] 刘晓杰[1] 

机构地区：[1]北京大学深圳医院影像中心,深圳518036 [2]北京大学深圳医院甲乳外科,深圳518036

出　　处：《临床放射学杂志》2010年第8期1039-1042,共4页Journal of Clinical Radiology

摘　　要：目的研究动态增强磁共振成像(DCE-MRI)中同侧血供增加在鉴别乳腺良恶性病变中的价值。资料与方法前瞻性研究21例乳腺摄影、超声或临床体检有乳腺病变患者的MRI资料。在最大强度投影(MIP)图像上,记录患侧乳腺血管的数目、直径、长度和可见性。根据Sardanelli血供评分,分为四个等级,即0～3分,分别代表乳腺乏血供或低血供(0分)、低血供(1分)、中等血供(2分)及高血供(3分);2～3分均被认为乳腺血供增加,与同侧乳腺癌相关。以病理结果作为参考标准,比较乳腺良恶性病变侧乳腺的血供差异。结果 21例患者MRI发现22个病灶,病理提示8个良性病变,14个恶性病变。良、恶性病变侧乳腺的血管平均数目±标准差分别为2.5±1.6、4.1±1.8(P<0.05);良、恶性病变侧乳腺的血供评分±标准差分别为2.0±0.8、2.5±0.5(P>0.05)。结论良、恶性病变侧乳腺的血管平均数目的差别有统计学意义,但是血供评分间的差别无统计学意义,因此Sardanelli血供评分在鉴别乳腺良恶性病变中的价值尚需进一步探讨和验证。Objective To evaluate the value of one-sided increased vascularity seen on dynamic contrast-enhanced breast MR images （DCE-MRI） in differential diagnosis of breast lesions. Materials and Methods A group of 21 patients with breast lesions detected by mammography, ultrasonography or clinical impression,were examined by DCE-MRI 2 to 14 days prior to the surgery. The maximum intensity projections （MIPs） obtained by postprocessing. The vessel number,size,length,and conspicuity were recorded and then scored according to the methods from Sardanelli et al. Then the difference of vascularity between benign and malignant breast lesions was compared using histopathology as a reference standard. Results Of 21 patients,there were 22 MRI detected lesions,8 benign and 14 malignant according to the final histology. The mean number of vessels ± SD per breast in the malignant cases was 4.1±1.8,compared with 2.5 ± 1.6 vessels per breast in benign cases （P〈0.05）.The mean MIP score ± SD per breast in the malignant cases was 2.5 ± 0.5,compared with 2.0 ± 0.8 per breast in benign cases （P〉0.05）.Thus,the mean MIP scores between benign and malignant breast lesions were not statistically different. Conclusion In our study,the mean number of vessels per breast between benign and malignant breast lesions had statistically significant difference.But ipsilaterally increased vascularity according to the methods from Sardanelli et al.is not a reliable sign of differentiating benign and malignant breast lesions.

关 键 词：乳腺 诊断 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]