乳腺良恶性病变的磁共振动态增强分析

目的:探讨磁共振动态增强扫描对诊断乳腺病变的价值。方法:对40例乳腺疾病患者(共57个病灶)分别进行磁共振平扫和动态增强扫描检查,分析病灶强化的形态学特征,测量时间-信号强度曲线分布类型、峰值时间和早期增强率,并进行统计学分析。结果:根据增强后的形态学特征对乳腺癌的敏感度为75.0%,特异度为69.7%,准确度为71.9%。良、恶性病灶的时间-信号强度曲线分布差异有统计学意义(P<0.001),诊断敏感度为91.7%,特异度为87.9%,准确度为89.5%;良、恶性病灶的峰值时间及早期增强率的差异有统计学意义(P<0.001),诊断敏感度分别为87.5%和75.0%,特异度分别为87.9%和84.8%,准确度分别为87.7%和80.7%。联合动态增强各项标准诊断乳腺癌的敏感度为95.8%,特异度为87.9%,准确度为91.2%。结论:时间-信号强度曲线、峰值时间及早期增强率具有较高的敏感性和特异性,结合增强的形态特征,可对大部分病变作出定性诊断,对良、恶性病变的诊断及鉴别诊断有重要价值。

Benign and malignant breast lesions in dynamic contrast-enhanced magnetic resonance analysis

Objective:Discuss the value of contrast-enhanced MRI in the diagnosis of breast lesions.Methods:40 cases(57 lesions) of breast disease patients underwent MRI plain scanning and dynamic scanning.Analyze the enhancement of morphological characteristics,measure the time-signal intensity curve type,time to peak and early enhanced rate.Results:Combining of morphological characteristics,the sensitivity is 75%,specificity is 69.7% and accuracy is 71.9%,for detection of breast cancer.The difference of the time-signal intensity curve between benign and malignant lesions are statistically significant(P<0.001).Diagnostic sensitivity is 91.7%,specificity is 87.9% and accuracy is 89.5%.The difference of early peak time rate increasing between benign and malignant lesions are statistically significant(P<0.001).Respectively for the diagnostic sensitivity are 87.5% and 75.0%,specificity are 87.9% and 84.8%,accuracy are 80.7% and 87.7%.Combining of dynamic scanning,the sensitivity is 95.8%,the specificity is 87.9% and the accuracy is 91.2% for detection of breast cancer.Conclusion:Time-signal intensity curve,the peak time and the rate of increasing have higher sensitivity and specificity.With enhanced characteristics,the most benign and malignant lesions were given diagnosis,which had important value in the diagnosis and differential diagnosis in the benign and malignant lesions.