DCE—MRI与^1H—MRS鉴别乳腺良恶性病变的前瞻性研究  

Comparison of dynamic contrast-enhanced MRI and ^1H-MRS in differentiating benign from malignant breast lesions

作　　者：陈美容[1] 罗学毛[1] 刘壮盛[1] 钟向阳[1] 吴标[1] 

机构地区：[1]江门市中心医院放射科,广东529070

出　　处：《影像诊断与介入放射学》2013年第3期196-200,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨磁共振动态增强（DCE—MRI）和质子波谱成像（^1HMRS）对乳腺良恶性病变的诊断价值。方法对乳腺钼靶或超声检查发现的63例女性患者共计83个乳腺病灶行DCE—MR检查，选取其中58个病灶行。H—MRS检查。分析增强后病灶的形态学表现和时间一信号强度曲线；观察胆碱峰的情况。所有病灶在MR检查后均行手术或穿刺活检。结果病理证实行DCE—MR检查的83个病灶中，恶性病变46个，良性病变37个；行^1H—MRS检查的58个病灶中恶性病变32个，良性病变26个。形态学表现诊断乳腺良恶性病变的敏感性为73．9％（34／46），特异性为94．6％（35／37），准确性为85．5％（71／83）；时间-信号强度曲线的敏感性为93．5％（43／46），特异性为73．0％（35／37），准确性为84．3％（70／83）；^1H—MRS敏感性65．6％（21／32），特异性为84．6％（22／26），准确性为74．1％（43／58）。形态学表现的特异性最高，敏感性较低；时间—信号强度曲线的敏感性最高，特异性最低；^1H—MRS的敏感性最低，特异性较高；3者诊断的准确性无显著差别。结论磁共振动态增强可鉴别乳腺良恶性病变，形态学表现应结合时间—信号强度曲线综合分析，必要时可联合波谱成像提高其特异性。Objective To compare dynamic contrast-enhanced （DCE） MRI and proton spectroscopy （^1H-MRS） for differentiating benign from malignant breast lesions. Methods 63 women with 83 suspicions breast lesions seen on mammography or ultrasound examinations underwent DCE MRI. 58 breast lesions were also examined with ill-MRS. The MR findings were compared with histology. Results Of 83 lesions on DCE MRI, 46 were malignant and 37 benign. Of 58 lesions on^1H-MRS, 32 were malignant and 26 were benign. The sensitivities, specificities and accuracy of morphological diagnosis were 73.9% （34/46）, 94.6% （35/37）, 85.5% （71/83）, respectively without significant difference from those of time signal intensity curves [93.5% （43/46）, 73% （35/37）, 84.3% （70/83）] and those of MRS [65.6% （21/32）, 84.6% （22/26）, 74.1% （43/58）]. Conclusions DCE MRI has high sensitivity for differentiating benign from malignant breast lesions. The specificity and accuracy can be improved by integrating with morphological features and MRS.

关 键 词：DCE—MRI ^1H—MRS 乳腺良恶性病变 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]