磁共振邻近血管征对乳腺良恶性肿瘤的鉴别诊断价值  

Value of the Adjacent Vessel Sign on Breast MRI for the Differentiation Between Benign and Malignant Breast Lesions

作　　者：陈敏[1] 刘玉涛[1] 董渭盈[2] 王艳萍[1] 朱红春[1] 杜中立[1] 王兰菁 

机构地区：[1]珠海市人民医院放射科(暨南大学附属第三医院),519000 [2]珠海市妇幼保健院,广东珠海519000

出　　处：《现代医用影像学》2013年第6期478-481,共4页Modern Medical Imageology

基　　金：珠海市2012年卫生局科研项目(编号2012097)

摘　　要：目的:分析63个乳腺肿瘤的磁共振表现,探讨病灶邻近血管征(AVS)在乳腺良恶性肿瘤鉴别诊断中的价值。材料与方法:回顾性分析经病理证实的60例63个乳腺肿瘤的MR动态增强图像,在工作站获得剪影图像及3D MIP图像,分析病灶邻近血管征与病灶良恶性、病灶大小的关系。结果:血管征在恶性肿瘤出现率(55%)明显高于良性肿瘤出现率(26.09%),差异有统计学意义(χ2=4.944,P<0.05)。病灶平均直径与血管征有关,病灶直径>2 cm的出现率(65.52%)明显高于直径≤2 cm的出现率(26.47%),差异具有统计学意义(χ2=9.664,P<0.05)。血管征分3型,单支血管型17例,其中恶性12例,良性5例;多支血管型7例,其中恶性6例,良性1例;血管扩张型4例,均为恶性。血管征诊断乳腺癌的敏感性为55.0%,特异性73.91%,阳性预测值78.57%,,准确度61.90%。结论:血管征在鉴别诊断中有较高价值,表现为多支血管及扩张血管征时高度提示恶性;血管征可以作为乳腺癌多因子评估的有力补充。Purpose： To investigate the MR imaging of 63 lesions and to evaluate the role of Adjacent Vessel Sign （AVS） for differentiating benign from malignant breast lesions. Materials and Methods： Dynamic contrast-enhanced MR breast scan of 60 patients （63 lesions） with histopathologically confirmed were evaluated retrospectively. The subtraction and 3D -MIP images were analyzed in MR work station. To verify the values of AVS and assess correlation between AVS and lesions sort, lesion size. Results ： The AVS was significantly associated with malignancy than benign lesions （ P 〈 0. 05 ） , lesions 〉 2 cm more often presented with an AVS than did those lesions 〈 2cm （ P 〈 0. 05 ） ; The AVS included 3 types, type I was one vessel included 17 lesions of 12 malignant and 5 benign lesions; type II was multi-vessels , with 6 malignant and 1 benign lesions; type III was dilated- vessel, all 4 lesions were malignant. The sensitivity and specificity of AVS were 55. 0% and 73.91%, the positive predictive value was 78.57%, accuracy was 61.90%. Conclusion： the AVS has high accuracy in differentiating benign from malignant breast lesions, especially multi-vessels or dilated-vessels were seen. AVS can be used to additional common practice of breast MR.

关 键 词：乳腺肿瘤 磁共振 最大密度投影 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]