3TMRI动态增强对钼靶检出乳腺可疑微钙化的诊断价值研究

目的：探讨3T核磁共振成像（magnetic resonance imaging，MRI）动态增强对钼靶检出乳腺可疑微钙化的诊断价值。方法：30例钼靶发现可疑微钙化病例完成MRI动态增强检查后行活检或切除术，以术后病理诊断为标准，分析可疑微钙化病变MRI动态增强的强化特点。结果：可疑微钙化病灶总数30个，其中良性11个，恶性19个。良性病变早期强化率均值约为（69．4±22．2）％，恶性病变早期强化率均值约为（115．2±37．4）％，二者之间差异具有统计学意义。良性病变MRI强化曲线多表现为上升型（72．2％），恶性病变MRI强化曲线多表现为流出型（73．7％），二者之间差异具有统计学意义。MRI动态增强对可疑微钙化灶的特异度为91．7％，远高于钼靶对可疑微钙化灶的特异度45．5％。结论：3TMRI动态增强结合钼靶检查，将乳腺可疑微钙化病变的形态学与血流动力学综合起来，对乳腺良恶性病变的定性诊断提供有效帮助。

The Value of 3T Dynamic Contrast Enhanced MRI in Diagnosis of Breast Lesions with Suspicious Microcalcifications Detected on Digital Mammography

Objective To assess the value of 3T dynamic contrast enhanced magnetic resonance imaging （MRI） in diagnosis of breast lesions with suspicious microcalcifications detected on digital mammography. Methods 30 patients with suspicious microcalcifications （BI-RADS3, 4 or 5）detected by mammography were biopsied or gotten surgery after undergoing dynamic contrast enhanced MRI. The pathologic results were obtained in all cases. The dynamic contrast-enhanced MRI characteristics of all the suspicious microcalcification lesions were analyzed. Results 30 suspicious calcifed lesions were totally included, postoperative pathological results showed that there were 11 benign lesions and 19 malignant ones. The early enhancement rate of benign lesions was （69.4±22.2） %. The early enhancement rate of malignant lesions was （115.2± 37.4） %. 72.2 % of benign lesions were enhanced as rising curve, and 73.7 % of malignant lesions were enhanced as flow curve. The difference between two groups showed significant. The specificity of dynamic contrast-enhanced MRI for suspicious microcalcifications was 91.7 %, which was far more higher than the specificity of mammography for suspicious microcalcifications 45.5 %. Conclusion Combined with mammography, 3T dynamic contrast-enhanced MRI links up with the morphology and hemodynamics of the lesions, which is helpful for the qualitative diagnosis of benign and malignant tumors of mammary glands.