乳腺非肿块强化病变的DCE-MRI特征及其与恶性肿瘤的关系  

DCE-MRI Features of Non-Mass Enhanced Breast Lesions and Their Relationship with Malignant Tumors

作　　者：贺春燕 张啸飞[1] 高岩峰[1] 吉茹[1] 仝伟兵 刘兵[1] HE Chunyan;ZHANG Xiaofei;GAO Yanfeng(Department of Radiology,People's Hospital Affiliated to Inner Mongolia Medical University,Hohhot,Inner Mongolia Autonomous Region O10020,P.R.China)

机构地区：[1]内蒙古医科大学附属人民医院放射科,呼和浩特010020

出　　处：《临床放射学杂志》2022年第10期1858-1862,共5页Journal of Clinical Radiology

基　　金：内蒙古医科大学青年项目(编号:YKD2022QN043)。

摘　　要：目的 探讨乳腺非肿块强化(NME)病变的动态对比增强磁共振成像(DCE-MRI)的影像特征,并探究可以鉴别乳腺NME病变良恶性的影像征象。方法 回顾性分析2017年6月至2021年6月内蒙古医科大学附属人民医院117例患者的乳腺DCE-MRI影像资料,年龄28~71岁,平均(52.1±5.6)岁。搜集、记录所有患者的临床资料及病灶随访结果,所有患者于术前均行乳腺DCE-MRI扫描。穿刺活检或手术病理结果呈良性和随访期间病变稳定或消退的NME归类为良性。比较分析乳腺良恶性NME的DCE-MRI影像特征。结果 恶性NME的分布类型中节段分布最多见(P=0.001),阳性预测值(PPV)较高(77.8%)。簇状环形强化模式与恶性NME之间有显著关联性(P=0.005),PPV为50.0%。所有恶性NME均无均匀强化模式。通过比较良、恶性NME的分布类型/强化模式组合发现节段分布/簇状环形强化模式与恶性NME显著相关(P=0.001),该组合的PPV为69.2%。恶性NME中最多见的时间-信号强度曲线(TIC)类型为Ⅱ型,其PPV为40.0%。恶性NME与DWI扩散受限有显著相关性,但其PPV较低(57.1%)。STIR序列显示NME中囊性结构的存在与恶性NME无显著相关性。结论 通过分析乳腺NME的DCE-MRI影像特征,发现节段分布和簇状环形强化与恶性NME有显著相关性,可以作为恶性肿瘤的预测指标。Ⅱ型TIC曲线和DWI扩散受限也与恶性NME存在相关性。Objective To explore the imaging features of dynamic contrast enhanced MRI(DCE-MRI)of non-mass enhancement(NME)breast lesions,and to explore the imaging features that can differentiate benign and malignant breast NME lesions.Methods From June 2017 to June 2021,117 cases of breast DCE-MRI images obtained in the Affiliated People’s Hospital of Inner Mongolia Medical University,aged 28-71(52.1±5.6)years,were retrospectively analyzed.Collected and recorded the clinical data and follow-up results of all patients.All patients underwent breast DCE-MRI scan before operation.NME with benign biopsy or surgical pathology results and stable or subsided lesions during follow-up were classified as benign.To compare the DCE-MRI features of benign and malignant NME of breast.Results Among the distribution types of malignant NME in this study,segmental distribution was the most common(P=0.001),and PPV was higher(77.8%).There was a significant correlation between cluster ring enhancement pattern and malignant NME(P=0.005),and PPV was 50.0%.No homogeneous enhancement pattern was found in all malignant NME.By comparing the distribution type/enhancement pattern combinations of benign and malignant NME,it was found that the segment distribution/cluster ring enhancement pattern was significantly correlated with malignant NME(P=0.001),and the PPV of this combination was 69.2%.The most common TIC type in malignant NME in this study was typeⅡ,and its PPV was 40.0%.Malignant NME was significantly correlated with DWI diffusion limitation,but its PPV was low(57.1%).In this study,STIR sequence showed that there was no significant correlation between cystic structure in NME and malignant NME.Conclusion Through the analysis of DCE-MRI features of breast NME,it is found that segment distribution and clustered annular enhancement are significantly correlated with malignant NME,which can be used as a predictor of malignant tumor.TypeⅡTIC curve and DWI diffusion limitation are also correlated with malignant NME.

关 键 词：乳腺病变 磁共振成像 非肿块强化 

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]