动态增强MR鉴别诊断乳腺X线摄影所见非肿块性病变  

Dynamic contrast enhanced MRI in differential diagnosis of non-mass-like breast lesions detected with full-field digital mammography

作　　者：司丽芳[1] 刘小娟[1] 杨开颜[1] 王丽[1] 蒋涛[1] 史瑞华[1] 翟仁友[1] 

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《中国医学影像技术》2014年第5期728-732,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价动态增强MRI(DE-MRI)对全视野数字化乳腺X线摄影(FFDM)检出的非肿块性病变的鉴别诊断价值。方法回顾性分析172例FFDM检出乳腺单发非肿块性病变患者,将病变分为局部结构扭曲(A)、局限性不对称致密(B)和单纯多发微小钙化灶(C)三种类型;根据分布特点,将单纯多发微小钙化灶分为簇状分布、线样分布、区域性分布、段性分布及弥漫散在分布型。分析DE-MRI形态学和血流动力学特点,以病理结果为金标准,评价DE-MRI的鉴别诊断价值。结果良性病变90例,恶性病变82例;DE-MRI对A型、B型和C型病变的诊断敏感度和特异度分别为95.45%(21/22)和66.67%(6/9),92.31%(24/26)和86.84%(33/38),82.35%(28/34)和72.09%(31/43)。结论 DEMRI对于鉴别数字化乳腺X线摄影检出的良恶性非肿块性病变具有重要价值。Objective To explore the value of dynamic enhanced MRI （DE-MRI） in patients with non-mass-like breast lesions detected with full-field digital mammography （FFDM）. Methods Image data of 172 patients with non-mass-like breast lesions detected with FFDM were retrospectively analyzed. Non-mass-like lesions were classified into three categories： Architectural distortion （A）, focal asymmetric density （B） and pure multiple microcalcification lesions （C）. The distribution of microcalcifications was classified into clustered, linear, regional, segmental and scattered type. DE-MRI and hemodynamic characteristics of the lesions were observed and compared taking pathological results as gold standards. Results Totally 82 malignant lesions and 90 benign lesions were confirmed by pathology. The sensitivity and specificity of DE-MRI for type A lesions was 95.45% （21/22） and 66.67% （6/9）, for type B lesions was 92.31% （24/26） and 86.84% （33/38）, for type C lesions was 82.35M （28/34） and 72.09% （31/43）, respectively. Conclusion DE-MRI is helpful to differentiating malignant from benign non-mass-like breast lesions detected with FFDM.

关 键 词：乳腺肿块 乳房X线摄影术 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]