BI-RADS 4类非肿块乳腺癌与非肿块乳腺良性病变MRI动态增强特征及ADC值分析  

DCE-MRI Features and ADC Value Analysis in Non-Mass Breast Cancer and Non-Mass Breast Benign Lesions of BI-RADS Category 4

作　　者：郜莹莹 杨爱梅[2] 彭杰[1] 刘艳[2] 古则努尔·亚森 代红 GAO Yingying;YANG Aimei;PENG Jie(The First Division Hospital of the Xinjiang Production and Construction Corps,Xinjiang Uygur Autonomous Regio 843000,P.R.Chin)

机构地区：[1]新疆生产建设兵团第一师医院CT核磁室,843000 [2]新疆医科大学附属肿瘤医院核磁室

出　　处：《临床放射学杂志》2018年第7期1101-1105,共5页Journal of Clinical Radiology

基　　金：兵团第一师医院院内课题资助项目(编号:KY16-04)

摘　　要：目的分析MRI诊断为BI-RADS 4类的非肿块样强化（NME）乳腺癌与NME良性病变的MRI动态增强特征及ADC值,提高对BI-RADS 4类乳腺良、恶性病变MRI特征的认识,为临床制定诊疗计划提供影像学支持。方法搜集行MRI诊断为BI-RADS 4类NME乳腺病变且有完整病理结果的70例患者资料,其中乳腺癌40例,乳腺良性病变30例,分析两者MRI特征并进行比较。结果 40例NME乳腺癌表现为节段性（n=19）,线样、线样分支状分布（n=12）为主;内部强化方式以集簇状（n=14）,簇状环形（n=12）为多;时间-信号强度曲线（TIC）多为Ⅱ型（n=24）,平均ADC值为（1.15±0.19）×10^-3mm^2/s。30例NME乳腺良性病变多表现局灶性分布（n=13）;内部强化方式以均匀（n=13）,不均匀（n=11）为多;TIC曲线以Ⅰ型（n=12）、Ⅱ型（n=10）为多,平均ADC值（1.29±0.26）×10^-3mm^2/s。经统计学比较两者在强化分布特征、内部强化方式比较中差异有统计学意义,χ^2值分别为22.750、15.239。强化分布特征比较中局灶性,节段性,线样、线样分支状分布差异有统计学意义,χ^2值分别为14.962、7.234、4.073;内部强化方式比较中均匀、集簇状、簇状环形强化差异有统计学意义,χ^2值分别为10.359、4.213、5.833。两者TIC曲线比较无统计学意义（χ^2=5.830）,ADC值比较差异有统计学意义（t=2.608）。结论BI-RADS 4类NME乳腺癌多表现为节段性,线样、线样分支状分布及集簇状、簇环形内部强化,相对乳腺NME良性病灶较低的ADC值与乳腺癌强化特点相结合可增大诊断权重;局灶性分布、内部均匀强化及相对较高的ADC值对BI-RADS 4类的NME良性病变有提示作用,TIC曲线对BI-RADS 4类乳腺NME良、恶性病变诊断价值有限。Objective The purpose of this study was to analyse DCE-MRI features and ADC value in non-mass breast cancer and non-mass breast benign lesions of BI-RADS category 4 to improve the judgment of both characteristic in MRI and provide imaging information for diagnosis and treatment planning of clinic. Methods We analyzed non-mass enhancement lesions of 70 MRI-BI-RADS category 4 were surgico-pathologically confirmed to evaluate their MRI imaging characteristic and compare their statistics,including 40 breast cancer patients and 30 patients of breast benign lesion. Results Forty non-mass enhancement breast cancer lesions showed mostly segmental,linear or linear branching distribution,clumped enhancement,cluster ring enhancement. 19,12,14 and 12,respectively. TIC type showed mostly Ⅱtype,24 lesions. The average of ADC value was（ 1. 15 ± 0. 19） × 10^-3mm^2/s. 30 cases of no-mass enhancement breast benign lesions their were almost focal distribution,homogeneous enhancement,heterogeneous enhancement. 13,13,11,respectively. TIC type showed mostly Ⅰ and Ⅱtype,12,10,respectively. The average of ADC value was（ 1. 29 ± 0. 26） × 10^-3mm^2/s. By comparing their enhanced distribution characteristics（ χ^2= 22. 750）,internal enhancement mode（ χ^2= 15. 239） and ADC value（ t =2. 608）,the distinction had statistically significant（ P〈0. 05）. There were not significant differences in TIC type（ χ^2=5. 830,P = 0. 054）. In addition,there were significant differences（ P〈0. 05） in focal（ χ^2= 14. 962）,segmental（ χ^2=7. 234）,linear or linear branching（ χ^2= 4. 073） of enhancement distribution. There were significant differences（ P〈0. 05） in homogeneous enhancement（ χ^2= 10. 359）,clumped enhancement（ χ^2= 4. 213）,cluster ring enhancement（ χ^2=5. 833） of internal enhancement mode. Conclusion non-mass enhancement breast cancer lesions showed mostly segmental,linear or linear branching distribution,clumped enhancement,cluster ring enhancement. The combination of l

关 键 词：非肿块强化 乳腺影像报告和数据系统 乳腺病变 

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]