磁共振动态增强扫描诊断乳腺导管内增生性病变的研究  

The Application of MRI Dynamic Contrast - enhanced Imaging in the Diagnosis of the Intraductal Hyperplasia Lesions of Breast

作　　者：王杏娟[1] 任小璐[1] 王雪梅[1] 马凤[1] 张小羽[2] 闫少宁[2] 刘云[2] 张志远[2] 

机构地区：[1]宁夏医科大学,银川740004 [2]宁夏医科大学总医院心脑血管病医院放射科,银川750002

出　　处：《宁夏医科大学学报》2012年第7期705-708,F0004,共5页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金资助(NZ09124)

摘　　要：目的探讨MRI动态增强成像(MRI Dynamic Contrast-enhanced Imaging,DCE-MRI)在乳腺导管内增生性病变中的诊断价值。方法经病理证实的27例共38个乳腺病灶作为研究对象,分析其动态增强时间-信号曲线类型,对比分析动态增强参数:最大增强线性斜率[smax(%.s-1)]、增强峰值(Peak High,PH)、增强峰值时间(Time-to-Peak,Tpeak)。结果导管原位癌(2.285±0.764)与终末导管-小叶上皮增生(1.139±0.587)、不典型增生(1.840±1.103)与终末导管-小叶上皮增生之间Smax差异均有统计学意义(P<0.05)。②导管原位癌、不典型增生、终末导管-小叶上皮增生动态增强时间-信号曲线Ⅰ型2/8(25.0%)、5/12(41.7%)、13/18(72.2%);Ⅱ型分别为4/8(50.0%)、Ⅱ型4/12(33.3%)、5/18(27.8%);Ⅲ型分别为2/8(25.0%)、3/12(25.0%)、0/18(0%);乳腺导管内增生性病变中TIC 52.63%表现为I型,I型曲线无PH、Tpeak。结论①病灶最大增强线性斜率(smax%.s-1)值越大,病灶越趋于恶性;根据Smax值结合TIC类型,可提高乳腺导管内增生性病变诊断的准确性。②PH、Tpeak在乳腺导管内增生性病变中的诊断意义不大。Objective To investigate the value of dynamic contrast enhanced imaging of MRI in the diagnosis of the intraductal hyperplasia Lesions of Breast.Methods 27 patients with 38 lesions proved by histological results were included and the time-intensity curve type,calculate parameters of dynamic,Smax,peak High and Tpeak were analyzed.Results The average Smax（%.s-1） of DCTS were ： 2.285 ± 0.764,ADH： 1.840 ± 1.103,TDLU hyperplasia： 1.139 ± 0.587.The smax difference among DCTS,ADH and TDLU hy-perplasia showed statistical significance（P 〈 0.05）.The results showed that T-SI curve of DCIS,I type 2 / 8（25.0%）,II type 4 /8（50.0%）,III type 2 /8（25.0%）,T-SI curve of ADH,I type 5 /12（41.7%）,II type 4 /12（33.3%）,III type 3 /12（25.0%）,T-SI curve of TDLU hyperplasia,I type 13 /18（72.2%）,II type 5 /18（27.8%）,III type 0 /18（0%）;52.63% T-SI curve of the intraductal hyperplasia Lesions of Breast show I type,and had no peak heigh（PH） time-to-peak（Tpeak）.Conclusion a） The larger lesions’ Smax value is,the more malignant lesions tend to;The combination of Smax value and T-SI curve type is very useful to improve the diagnostic accuracy of intraductal hyperplasia lesions of breast.b） PH and Tpeak are not very useful in the diagnosis of intraductal hyperplasia lesions of breast.

关 键 词：乳腺 导管内增生 磁共振成像 时间-信号曲线 

分 类 号：R655.8[医药卫生—外科学]