MRI动态增强扫描在乳腺良恶性病变中的诊断价值

摘要

目的:评价MRI动态增强扫描在乳腺良恶性病变中的诊断价值.方法:回顾性分析58例经病理证实的乳腺病变的 MRI动态增强扫描强化形态及时间-信号强度曲线图表现.结果:良性病变共22 例(纤维腺瘤8例,导管内乳头状瘤5例,乳腺囊肿5例,导管囊状扩张伴慢性炎症1例,囊性乳腺病 3 例);恶性病变共 36例(浸润性导管癌28例,浸润性小叶癌3例,导管原位癌 2例,浸润性乳头状癌 2 例,髓样癌1例).恶性病变多表现为边缘毛刺、分叶征或边缘模糊,环状强化或不规则强化.良性病变多表现为边缘光滑整齐的均匀强化,其中5例囊肿无强化.其中形态学阳性预测值为89.47%,阴性预测值为90.00%,准确率为89.66%.强化表现阳性预测值为89.74%,阴性预测值为94.74%,准确率为91.38%.时间-信号强度曲线图:22例良性病变,13例(59.09%)表现为Ⅰ型,8例(36.36%)表现为Ⅱ型,1例(4.55%)表现为Ⅲ型;36例恶性病变,1例(2.78%)表现为Ⅰ型,9例(25.00%)表现为Ⅱ型,26例(72.22%)表现为Ⅲ型,阳性预测值为79.55%,阴性预测值为92.86%,准确率为82.76%.结论:乳腺MRI动态增强的形态学表现与时间-信号强度曲线图相结合,在良恶性病变的诊断与鉴别诊断中具有较高的价值.%O bjective T o evaluate the dynam ic contrast-enhanced M R in breast benign and m alignant lesions .M ethods :R etrospectively analyze M R dynam ic enhanced scanning aggrandizement form and tine-signal intensity curve perform ance of 58 cases patho logically proven breast lesions .Results :Benign lesion swere 22 patients ( fiber adenom a in 8 cases , in traductal papillom a in 5 cases, mamm arycysts in 5 cases, catheter cystic dilatation with chronic inflam mation in 1 case , cystic mam mary gland disease in 3 cases) , malignant change of36 patients (infiltrating ductalcarcinom a in 28 cases, infiltrating lobular carcinom a in 3 cases,ductalcarcinom a in situ in 2 cases, invasive papillary carcinom a in 2 cases, medullary carcinom as 1 case) .Malignant change much performed edgeburr, sign of lobulation or edgeblur, annular strengthen or irregular aggrandizem ent.Benign lesions much perform ed sm ooth edges and tidy unform aggrandizem ent, of which 5 cases of cyst without aggrandizem ent.Shape of positive prediction was 89.47％ , negative prediction was 90.00％ , accuracy was 89.66％ .Strengthen perform ance : positive prediction was 89.74％ , negative prediction was 94.74％ , accuracy was 91.38％ .Time- signalin tensity curve , 22 cases benign lesions, 13 cases (59.09％ ) for type Ⅰ , 8 cases (36.36％ ) for type Ⅱ , 1 cases (4.55％ ) for type Ⅲ ; 36 cases of malignant lesions, 1 case (2.78％ ) for typeⅠ , 9 (25.00％ ) cases for type Ⅱ , 26 cases (72.22％ ) for type Ⅲ , positive prediction was 79.55％ , negative prediction was 92.86％ , accuracy was 82.76％ .Conclusion : It' s very valuable for com bining MR dynamic enhancement of b reast morpho log ical features with time- signal inten sity curve in diagnosis and differen tial diagno sis of benign and malignant lesions .