VIEWS磁共振技术在乳腺病变诊断中的应用初步研究

目的探讨VIEWS磁共振动态增强技术在乳腺病变诊断中的价值。方法回顾分析已行MRI平扫及VIEWS技术动态增强连续5min 5期扫描检查并减影的78例经病理证实的乳腺病变患者,分析比较良、恶性病变的形态学特征、强化模式及时间信号强度曲线。结果 78例患者共101个病灶,其中恶性病变38例共60个病灶、良性40例共41个病灶。良性病变增强后多呈圆形、边缘光整、边界清楚、无毛刺,强化均匀;强化模式大多表现为逐渐强化。恶性病变形态不规则,边缘有毛刺或蟹足征;本组所有恶性病灶均表现为早期（1～2min内）明显强化。良恶性病变的时间-信号强度曲线表现不同,良性病变多呈Ⅰ型＂持续型＂（25/37）,恶性病变多呈Ⅲ型＂廓清型＂（51/60）,差异有统计学意义（χ2=55.2,P〈0.001）。结论 VIEWS动态增强扫描有利于显示病变的形态学和血液动力学信息,对乳腺良恶性病变的诊断和鉴别诊断有重要意义。增强后第1分钟有利于观察病灶早期血供特征,第5分钟有利于观察肿瘤的边缘浸润特征及肿块内的结构。第1分钟明显强化、肿块不规则、边缘有毛刺或蟹足征、时间信号曲线呈廓清型是乳腺癌的特征性改变;各期减影图显示强化病灶更清晰、更直观。

Diagnosis of breast lesions by views enhanced MRI

Objective To investigate the value of VIEWS dynamic enhanced MRI in the diagnosis of breast lesions.Methods78 patients with breast lesions,surgically and pathologically proved,were enrolled in our series.All lesions were evaluated with pain and VIEWS dynamic enhanced MRI.MRI VIEWS was performed on a continuous 5 minutes and 5 sequences of scan and subtraction of breast lesions.The morphological manifestations of enhancing patterns and the types of time-signal intensity curve of the lesions were analyzed.ResultsThere were 60 malignant and 41 benign lesions in our collection of 78 patients.A great number of the benign lesions show rotund and smooth margins,while the malignant lesions revealed irregular,speculated and lobular ones or crab foot signs.The enhancement patterns of malignant and benign lesions were different.Significant difference in the types of time-signal intensity curve between benign and malignant lesions（χ2= 55.2,P0.001） were shown.The most of benign lesions showed gradually enhanced.All malignant lesions in our series showed early（1～2 minutes） significantly enhanced.Benign lesions often showed I ＂persistent-type ＂（13/15）,malignant lesions showed Ⅲ ＂clearance-type＂（52/60）.Conclusion VIEWS dynamic enhanced MRI of breast offered conspicuous signs and more information in morphological features of the lesions and the characteristics of time-signal intensity curves which reflected the hemodynamics of benign and malignant lesions.The features of the lesions was thought to be a useful signs to differentiate between benign and malignant lesions.The first 1 minute enhanced scan was benefit to show the early blood supply of lesions.The fifth minute enhanced scan was favorable characteristics of edge and infiltration within the structure of lesions.Significantly enhanced in the first 1 minute,irregular,speculated and lobular ones or crab foot signs,the Ⅲ-type time-signal curve were the characteristics of breast cancer.The subtraction diagram of five stages shows more clearly,more intuitive of the lesions.