MRI随访在乳腺BI-RADS4类病变的诊断价值  

Diagnosis of MRI Following-up in Breast Lesions Categorized as BI-RADS 4

作　　者：朱志清[1] 姚明[1,2] 律苗[3] 程流泉[1] 李晓[1,4] 郑一琼 

机构地区：[1]解放军总医院放射科,北京100853 [2]北京市顺义区医院放射科,北京101300 [3]武警总医院信息科,北京100039 [4]河南省平煤能化集团总医院放射科,河南平顶山467000 [5]解放军总医院普通外科,北京100853

出　　处：《中国医学影像学杂志》2016年第4期266-269,共4页Chinese Journal of Medical Imaging

摘　　要：目的采用MRI随访观察乳腺病灶的变化,评价MRI随访对乳腺影像报告和数据系统（BI-RADS）4类病变的临床诊治指导价值。资料与方法回顾性分析首次MRI诊断为BI-RADS 4类患者34例,间隔3周~1年,采用MRI随访观察病灶的稳定性,当病灶增强形态、表观扩散系数（ADC）值及增强时间-信号曲线（TIC）类型提示向恶性转化时,则分类升级并推荐患者进行活检或切除;反之,分类降级建议继续随访。结果被关注病灶共计36个,随访期间升级病灶19个,其中病理证实15例恶性、1例乳腺炎;10例保持分类不变,8例病理证实6例恶性;病灶降级7例,病理证实良性1例。结论利用MRI对BI-RADS 4类病灶进行随访,当病灶增强形态、ADC值及TIC类型其中之一提示向恶性转化时,需要及时行活检或外科处理,反之可以继续随访,这种随访方式可以避免乳腺病灶的过度处理。Purpose To evaluate the clinical efficacy of MRI following-up in management of breast lesions initially categorized as 4. Materials and Methods The retrospective study included 34 patients whose lesions were initially categorized as BI-RADS 4 and had MRI follow-up within 3 weeks to 1 year. With comparison to the initial MRI examination, the lesion stability was assessed on the follow-up MRI. The enlargement in size, ADC value decreasing or TIC types elevation within the follow-up duration meant lesion deterioration and the categorization upgrading, or the categorization degraded. Results Totally, 36 lesions were included. Of the 19 upgraded lesions, 16 were malignant and 1 were mastitis pathologically. Of the 10 stable lesions, 6 were pathologically malignant. Of the 7 degraded lesions, 1 were pathologically benign. Conclusion The enlargement in size, ADC value decreasing and TIC type elevation on the follow-up MRI indicated the malignancy of the initial BI-RADS category 4 lesions and biopsy or lumpectomy were prompted. The followup MRI is an alternative for the management of breast risk lesion.

关 键 词：乳腺肿瘤 乳腺影像报告和数据系统 磁共振成像 随访研究 

分 类 号：R737.9[医药卫生—肿瘤] R730.41[医药卫生—临床医学]