乳腺MR功能成像对乳腺病变的诊断价值研究

目的评估功能代谢成像技术在乳腺病变中的诊断价值。方法 49个病灶在同一次乳腺MRI检查中,依次行MR常规序列平扫、扩散、灌注、动态增强及波谱成像。结果将早期信号丢失率(SDR)=19.84%、早期信号强化率(SER)=55.5%以及出现MRS-Cho峰分别作为诊断恶性病灶的阈值,诊断敏感性、特异性分别为90.3%、90.3%、87.1%;94.4%、55.6%、66.7%。SDR诊断效能明显高于SER(A值分别为0.824、0.971,P=0.000)。联合诊断的敏感性、特异性、准确性分别为96.7%、94.4%、96%。结论扩散、灌注、动态增强及波谱成像技术在鉴别乳腺病灶的良、恶性方面各有优势,联合多种功能成像技术能够明显提高乳腺癌诊断的准确性。

The Diagnostic Value of MR Functional Imaging in Breast Lesions

Purpose To assess the diagnostic value of MR Functional lmaging fMRI in patients with breast lesions. Methods 49 lesions underwent MR conventional plain scanning, Diffusion weighted imaging （DWI）, T2＊-weighted first-pass perfusion imaging （PWI- T2＊Wl）,dynamic contrast-enhanced T I -weighted imaging （DCE-T 1Wl） and magnetic reso- nance spectroscopy （MRS） in proper order in a br-east MRI examination. Results Signal intensity decrease rate （SDR）=19.84%, signal intensity enhancement rate （SER） = 55.5% and MRS-Cho peak were used as threshold to diagnose malignant lesion. The diagnostic sensibility and specificity of SDR, SER, and MRS-Cho peak were 90.3% 90.3% 87.1% 94.4%, 55.6% 66.7%, respectively. The diagnostic efficacy of SDR was obviously higher than SER （A value was 0.824 and 0.971, P=0.000）. The combination of fMRI had a sensitivity of 96.7%, specificity of 94.4%. and accuracy of 96.0%. Conclusion PWI- T2＊WI, DCE-TIWI and MRS PWI-T2＊WI have respective adwmtages in differential diagnosis of breast benign and malignant lesions. The combination of IMRI can improve the diagnostic accuracy of breast cancerL