3．0T增强MRI血管成像对乳腺良恶性病变的诊断价值  

The application of 3. 0T contrast-enhanced MR angiography in the differentiation of malignant from benign lesions of the breast

作　　者：王瑞[1] 刘万花[1] 李逢芳[1] 彭程宇[1] 

机构地区：[1]东南大学附属中大医院放射科,江苏南京210009

出　　处：《实用放射学杂志》2013年第3期384-387,共4页Journal of Practical Radiology

摘　　要：目的 探讨3.0T MRI增强血管成像对乳腺良、恶性病变的鉴别诊断价值。方法 110例乳腺疾病患者共111个病灶均行3.0T MRI动态增强检查并经病理证实，应用MR血管减影图像重建最大信号投影,观测良、恶性病变双侧血管数并记录分析，并以患侧血管增加数≥2或出现病灶邻近血管作为恶性病变诊断标准，分别计算两者对恶性病变的诊断价值及其与病灶最大径的相关性研究。结果 ①恶性病灶的患侧及对侧平均血管数分别为4.0及1.5，于良性病灶分别为2.0及1.0，良性及恶性病灶双侧平均血管数比较均有显著统计学意义（P值均〈0.05）；良、恶性病灶组间比较，患侧与对侧的平均血管数亦均有显著性差异（P值均〈0.05）。②恶性病灶最大径与患侧增加血管数及病灶临近血管数成正相关，且恶性病灶比良性病灶更容易出现患侧血管增加及病灶临近血管。③乳腺炎症会降低患侧血管增加及病灶临近血管对乳腺恶性病变诊断的特异性，而且对病灶临近血管影响最大，分别由87.0%及78.3%降到82.1%及66.1%。结论 3.0T MRI增强血管成像对乳腺良、恶性病变具有一定的鉴别诊断价值。Objective To evaluate the value of 3.0T contrast-enhanced MR angiograms in the differentiation of malignant from benign lesions of the breast. Methods Maximum intensity projections （MIPs） were obtained with subtraction images for 110 patients with 111 breast lesions proved histopathologically. The mean vessels numbers were estimated for both sides. All images were evaluated for both ipsilateral increased vascularity （difference in the number of both side vessels≥2） and adjacent vessel sign. The values of these signs in the diagnosis of malignancy were assessed,and considered with the association between vessels and the sizes of breast lesions. Results ①The mean number of vessels were 4. 0 and 1. 5 in the ipsilateral,contralateral breasts in malignant grope,the mean number of vessels were 2.0 and 1.0 in the ipsilateral, contralateral breasts in benign grope,it had significant differences between ipsilateral and contralateral breasts （all the P value.〈0.05） for both malignant and benign grope;there were significant differences between malignant and benign grope whether ipsilateral or contralateral breast（ all the P value d0.05 ）. ②Ipsilateral increased vascularity and the adjacent vessel sign were more often seen in patients with malignant lesions than those with benign lesions, which had a positive relationship with the malignant lesions size. ③Breast inflammation could reduce the diagnostic specificity of ipsilateral increased vaseularity,and especially influence the adjacent vessels sign in malignant breast lesions,by 87.0% and 78.3% to 82. 1 and 66.1 %respectively. Conclusion 3.0T contrast-enhanced MR angiography has differential diagnostie significance for benign and malignant lesions.

关 键 词：动态增强 MR血管成像 最大信号投影 乳腺癌 

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