造影MRM在乳腺导管癌中的诊断价值

Tel：0431-4643636;E-mail：） 目的：研究乳腺磁共振成像(MRM)在判定乳腺疾病性质中的诊断价值。方法：145例经外科手术证实的乳腺疾病患者，手术前均行造影MRM检查，分析早期强化倍数和延迟强化模式两项参数与不同乳腺疾病的关系。结果：①早期强化倍数大于3倍为恶性病变、小于1倍为良性病变的可能性大。②下降型延迟强化模式是诊断乳腺导管癌的重要参数，浸润性导管癌中占81%，导管内癌中占65%，良性病变中占14%。③若以下降型延迟强化模式及上升型延迟强化模式早期强化倍数大于2.5倍为乳腺导管癌的诊断标准：87.9%的浸润性导管癌、73.1%的导管内癌符合此标准，21.4%的良性病变亦符合此标准会被错误诊断。结论：延迟强化模式参数和早期强化倍数相结合与单纯以延迟强化模式鉴别病变性质相比，乳腺导管癌诊断正确率得到提高，但良性病变的正确诊断率下降。

Diagnostic value of MR mammography in breast ductal carcinom

Objective To study the diagnostic value of MR mammography(MRM) in judging the nature of breast disease.Methods 145 cases with breast disease were retrospectively studied to investigate the relationships between two parameters(early-phase enhancement rate and the type of the delayed enhancement) and different breast diseases.All patients underwent MRM examination before surgical operation.Results ①Strengthen multiple in early stage larger than 3 times was inclined to malignant lesion;Strengthen multiple smaller than 1 time was inclined to benign lesion.②Drop type of delayed enhancement was the important parameter in diagnosis of ductal carcinoma.If drop type of delayed enhancement was viewed as the diagnosis standard of the ductal carcinoma of breast only:81% cases with invasive type of the ductal carcinoma,65% cases with noninvasive type of the ductal carcinoma had been diagnosed correctly;14% cases with benign breast lesions had been diagnosed exaggeratedly.③If strengthen multiple in early stage larger than 2.5 times in rising type of delayed enhancement and drop type of delayed enhancement was viewed as the diagnosis standard of the ductal carcinoma of breast,87.9% cases with invasive ductal carcinoma,73.1% cases with noninvasive ductal carcinoma had been diagnosed correctly;21.4% cases within benign breast lesions had been diagnosed exaggeratedly.Conclusion Compared with differential of disease nature by the type of the delayed enhancement only,the correct rate of diagnosis of breast ductal carcinoma mentioned above is raised if two parameters are combined.But the correct diagnosis rate of benign lesions is decreased.