磁共振动态增强、扩散加权成像联合应用对乳腺疾病的诊断价值  

Diagnostic value of dynamic contrast-enhanced MR imaging, diffusion-weighted imaging and combined scanning in breast lesions

作　　者：李玮[1] 石惠[2] 平学军[2] 李德刚[3] 

机构地区：[1]内蒙古包头市中心医院磁共振室,包头014040 [2]宁夏医科大学总医院心脑血管病医院放射科,银川750001 [3]内蒙古包钢医院影像中心,包头014010

出　　处：《癌症进展》2013年第6期562-566,共5页Oncology Progress

摘　　要：目的探讨磁共振动态增强(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)、扩散加权成像(diffusion weighted imaging,DWI)及其联合应用对乳腺疾病诊断的价值。方法乳腺病变患者75例,共80个病灶。观察病灶形态、信号特征、时间信号强度曲线(time signal intensity curve,TIC)、早期强化率。联合诊断采用序列诊断及平行诊断两种方法。评价DCE-MRI、DWI及联合成像对乳腺疾病定性诊断的价值,结果恶性病变形状不规则或呈分叶状、多见毛刺或棘状突起、不均匀强化或环状强化、早期强化明显、TIC多为Ⅲ型。乳腺良性病变多形态规则、边缘清晰、呈均匀强化、早期强化率低、TIC多为Ⅰ型。DCE-MRI联合DWI平行诊断,提高了诊断的灵敏度及准确率,有助于对病变进行定性诊断。结论 DCE-MRI及DWI诊断均有较高的灵敏度、特异度及准确率,推荐作为常规检查序列。联合DCE-MRI和DWI平行诊断,为疾病的诊断提供更丰富、更有价值的信息,诊断的灵敏度和准确率较高,有助于病变性质的判定。Objective To investigate the value of dynamic contrast-enhanced imaging （DCE-MRI）, diffusion weigh- ted imaging （DWI） , and combination of the two methods for the diagnosis of breast lesions. Method We analyzed 80 le- sions from 75 patients, the images were reviewed regarding shape, contour, type of time-signal intensity curve （TIC） , and the early enhancement rate （ASI） after ejection of Gd-DTPA was calculated. Combined scanning included sequential and parallel scanning. The validities of dynamic contrast-enhanced MR imaging, DWI, and combination of the two methods were evaluated. Result The typical malignant features were irregular shape, spiculated margin and rim enhancement, and the early enhancement rate was obvious, with distribution of curve type mostly was type III. The great majority of benign le-sions were smooth and well delineated, homogeneously enhanced, with low early enhancement rate, of which the distribu- tion of curve types for benign lesions mainly was type I . The combination of DCE-MRI, DWI was evaluated in respect of qualitative diagnosis. Conclusion Both DCE-MRI and DWI are of high sensitivity, specificity and accuracy, and are rec- ommended to be routine examinations. The combination of DCE-MRI and DWI is useful to increase sensitivity and accura- cy, providing valuable and sufficient information for the diagnosis of those lesions.

关 键 词：乳腺病变 磁共振动态增强成像 扩散加权成像 

分 类 号：R737.9[医药卫生—肿瘤]