DWI和Vibrant动态增强MR成像在乳腺癌中的诊断价值

目的：探讨MR扩散加权成像（DwI）和Vibrant技术在乳腺癌中的诊断价值。方法：搜集经病理证实的55例乳腺癌患者，55例均行MRI平扫、DWI及Vibrant成像，扩散系数b值为1000s／mm2，测量正常腺体组织、病灶的ADC值及病灶早期强化率，确定动态增强时间-信号强度曲线类型；将Vibrant图像进行3D最大强度投影（MIP）重组，观察病灶不同角度的特征。结果：乳腺癌平均ADC值[（0．92±0．25）×10-3mm2／s]较正常腺体[（1．73±0．13）×10-3mm2／s2明显减低，差异有统计学意义（P〈0．05）；恶性肿瘤灌注曲线表现为廓清型（49例）或平台型（16例），病灶早期强化率为1．85±0．58。3DMIP图像可整体观察病灶形态，有利于供血动脉的显示。结论：MRI平扫、DwI、Vibrant成像结合3DMIP图像特征可为乳腺恶性肿瘤的诊断提供更多信息。

Assessment of breast carcinoma with MRI,DWI and vibrant imaging

Objective：To evaluate the diagnostic value of magnetic resonance diffusion weighted imaging （DWI） and vibrant imaging in the diagnosis of breast carcinoma. Methods：Fifty-five patients with pathology proven breast carcinoma were recruited. All of them had plain MRI,DWI （b= 1000s/mm2 ） and vibrant imaging. The ADC values of normal breast tissue and cancer lesion were measured. The early enhancing rate,dynamic enhanced time period and the type of time inten- sity curve were defined. The vibrant images were reformatted with 3D-MIP,and the image characteristics were observed at different points of view. Results： The mean ADC value of breast carcinoma was （0. 92 ± 0. 25） ×10-3 mm2/s, which was markedly lower than that of normal tissue[ （ 1.73 ±0.13 ）× 10-3 mm2 /s], with significant statistic difference （ P % 0.05 ）. The perfusion curves of malignant tumor showed wash in / wash out type （49 patients） or platform type （16 patients）,the early enhanced rate of tumor was 1.85±0.58. The morphology of entire tumor could be revealed on 3D MIP images, and these were helpful to show the feeding arteries. Conclusion： The image characteristics of plain MRI,DWI and vibrant ima- ging in combination with 3D MIP image can significantly improve the diagnostic accuracy of breast malignant tumors.