乳腺结节状病变的MRI诊断  

MRI Diagnosis of Nodular Breast Lesions

作　　者：郝建成 孙丽娟[2] 郝金钢[3] HAO Jian-cheng;SUN li-juan;HAO jin-gang(Dept,of Imaging,Wuhu First People's Hospital,Wuhu Anhui 241000;Magnetic Resonance Room,Tongliao Hospital of Inner Mongolia,Tongliao Inner Mongolia 028000;Dept,of Radiology,The Second Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]芜湖市第一人民医院影像科,安徽芜湖241000 [2]内蒙古通辽市医院磁共振室,内蒙古通辽028000 [3]昆明医科大学第二附属医院放射科,云南昆明650101

出　　处：《昆明医科大学学报》2021年第10期127-131,共5页Journal of Kunming Medical University

基　　金：云南省医学学科带头人培养项目(D-2018012)。

摘　　要：目的探讨乳腺良、恶性结节病变的MRI诊断价值。方法回顾性分析来芜湖市第一人民医院就诊的乳腺疾病患者71例,均经过病理证实结节状病灶,术前均进行MRI多参数成像,选取动态增强(DCE-MRI)和DWI数据进行分析,经处理得到:时间-信号曲线(TIC),达峰时间(Tpeak),峰值强化率(PER),峰值(SImax)及表观扩散系数(ADC),结合形态学特征:边缘毛糙、环形强化、边缘毛刺征及分叶征进行分析。结果恶性病灶43例,良性病灶28例。TIC时间-信号曲线Ⅰ型22个,以良性为主17例,恶性5例;Ⅱ型35例,恶性为主24例,良性11例;Ⅲ型14个,均为恶性;良、恶性病灶TIC曲线类型有差异,差异有统计学意义(P<0.05);良、恶性病变的峰时(Tpeak),峰值强化率(PER),峰值(SImax)及ADC有显著差异,差异有统计学意义(P<0.05)。边缘毛糙33例,均为恶性;环形强化24例,良性5例,恶性19例;毛刺征29例,均为恶性;有分叶征42例,良性7例,恶性35例。良恶性病灶形态学,差异有统计学意义(P<0.05)。结论磁共振动态增强扫描血流动力学参数、ADC结合形态学特征对乳腺结节状良、恶性疾病的诊断具有重要价值。objective To investigate the value of MRI diagnosis of nodular breast benign and malignant lesions.Methods Retrospective analysis of 71 patients with nodular breast disease confirmed by pathology in our hospital,Perform MRI multi-parameter imaging before surgery,Select DCE-MRI and DWI for analysis,After processing:TIC time-signal curve,peak time,peak enhancement rate,SImax peak and ADC apparent diffusion coefficient,Combined with morphological characteristics:rough edges,ring strengthening,edge burr sign and leaf leaf sign for analysis.Results 43 malignant lesions,28 benign lesions.There were 22 TIC time-signal curves of typeⅠ,with 17 cases of benign lesions and 5 cases of malignant lesions.There were 35 cases of typeⅡ,of which24 were malignant and 11 were benign.14 of typeⅢare all malignant lesions.The TIC time-signal curve types of benign and malignant lesions are different,and the difference is statistically significant(P<0.05);The peak time,peak enhancement rate,SImax peak and ADC apparent diffusion coefficient of benign and malignant lesions were significantly different,and the difference was statistically significant(P<0.05).Conclusion MRI dynamic enhanced scanning hemodynamic parameters,ADC combined with morphological features are of great value in the diagnosis of breast nodular benign and malignant diseases.

关 键 词：乳腺结节 恶性病变 良性病变 MRI DCE-MRI 

分 类 号：R737.13[医药卫生—肿瘤]