MRI乳腺影像报告和数据系统在非肿块强化病变中的诊断价值研究  

Application of MRI Breast Imaging Report and Data System in the Diagnosis of Breast Lesions Presenting as Non-Mass Enhancement

作　　者：崔晓琳[1] 周纯武[1] 李静[1] 李二妮[1] 张仁知[1] 赵莉芸[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院影像诊断科,100021

出　　处：《临床放射学杂志》2015年第4期532-537,共6页Journal of Clinical Radiology

摘　　要：目的探讨MRI乳腺影像报告和数据系统(BI-RADS)在非肿块强化病变的诊断和鉴别诊断价值。方法搜集2010年10月至2013年1月接受MRI检查并经病理证实或临床随诊1年以上的203例非肿块强化患者资料,根据BI-RADS分类研究其动态增强形态学特征和时间-信号强度曲线(TIC)、进行分类并与病理学结果相对照。结果 203例患者中共209个非肿块强化病灶,良性病变58个(27.75%),恶性病变151个(72.25%)。良性病变中以腺病最多,占25.86%(15/58);恶性病变中浸润性导管癌最多,占47.68%(72/151),且均伴有导管原位癌成分。在形态学上,良恶性病变在局灶性分布、节段性分布、簇状环形强化间的差异有统计学意义(P值分别为0.001、0.003、0.010);良恶性病变在TIC类型Ⅰ型和Ⅲ型的差异有统计学意义(P值分别为0.000、0.018)。恶性病变的危险性相关因素包括节段性分布、簇状环形强化、TIC为Ⅲ型(OR值分别为3.5、4.22、2.48)。MRI BI-RADS分类对非肿块恶性病变诊断的敏感性、特异性、准确性分别为94.04%、55.17%、83.25%。结论 MRI BI-RADS是诊断和鉴别诊断乳腺非肿块强化病变的有效方法,具有较高的敏感性和准确性,但特异性较低。Objective To evaluate MRI breast imaging report and data system （BI-RADS） in diagnosing and differentiating breast lesions presenting as non-mass enhancement （NME）. Methods A total of 203 patients with NME breast lesion, who had received MR1 examination during the period from October 2010 to January 2013, were enrolled in this study. The diagnosis was confirmed by pathology or by clinical following-up for more than one year. Based on BI-RADS classification, the dynamic enhancement morphologie features and the time-intensity curve （ TIC ） were analyzed ; the lesions were classified, and the findings were compared with pathological results. Results A total of 209 lesions were detected in the 203 patients, including 58 benign lesions （27.75%） and 151 malignant lesions （72.25%）. In the benign lesions, adenosis was most often seen （ 15/58, 25.86% ） ; while in the malignant lesions, invasive duetal carcinoma was most cummunly observed （72/151, 47.68% ） , containing the component of ductal carcinoma in situ in all patients. Statistically significant differences in focal distribution, segmental distribution and cluster ring enhancement existed between the benign and malignant lesions （P =0. 001 , P =0. 003 and P =0. 010 respectively）. The differences in TIC type Ⅰ and type Ⅲ between the benign and malignant lesions were statistically significant （P = 0. 000 and P = 0. 018 respectively）. The risk factors of the malignant lesions included segmental distribution, cluster ring enhancement and TIC type Ⅲ （ OR = 3.5, OR = 4.22 and OR = 2.48 respectively）. The sensitivity, specificity and accuracy of MRI BI-RADS for the diagnosis of malignant NME lesions were 94.04% , 55.17% , and 83.25% respectively. Conclusion MRI BI-RADS is an effective method for the diagnosis and differentiation of malignant and benign NME lesions. This nlethod cames higher sensitivity and accuracy, although its specificity is lower.

关 键 词：乳腺病变 磁共振成像 乳腺影像报告和数据系统 非肿块强化 

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