MRI动态增强扫描在乳腺良恶性病变中的诊断价值

目的:评价MRI动态增强扫描在乳腺良恶性病变中的诊断价值。方法:回顾性分析58例经病理证实的乳腺病变的MRI动态增强扫描强化形态及时间-信号强度曲线图表现。结果:良性病变共22例(纤维腺瘤8例,导管内乳头状瘤5例,乳腺囊肿5例,导管囊状扩张伴慢性炎症1例,囊性乳腺病3例);恶性病变共36例(浸润性导管癌28例,浸润性小叶癌3例,导管原位癌2例,浸润性乳头状癌2例,髓样癌1例)。恶性病变多表现为边缘毛刺、分叶征或边缘模糊,环状强化或不规则强化。良性病变多表现为边缘光滑整齐的均匀强化,其中5例囊肿无强化。其中形态学阳性预测值为89.47%,阴性预测值为90.00%,准确率为89.66%。强化表现阳性预测值为89.74%,阴性预测值为94.74%,准确率为91.38%。时间-信号强度曲线图:22例良性病变,13例(59.09%)表现为Ⅰ型,8例(36.36%)表现为Ⅱ型,1例(4.55%)表现为Ⅲ型;36例恶性病变,1例(2.78%)表现为Ⅰ型,9例(25.00%)表现为Ⅱ型,26例(72.22%)表现为Ⅲ型,阳性预测值为79.55%,阴性预测值为92.86%,准确率为82.76%。结论:乳腺MRI动态增强的形态学表现与时间-信号强度曲线图相结合,在良恶性病变的诊断与鉴别诊断中具有较高的价值。

Diagnostic value of dynamic contrast enhanced MR in breast benign and malignant Lesions

Objective： To evaluate the dynamic contrast-enhanced MR in breast benign and malignant lesions. Methods： Retrospectively analyze MR dynamic enhanced scanning aggrandizement form and time-signal intensity curve performance of 58 cases pathologically proven breast lesions. Results：Benign lesions were 22 patients （fiber adenoma in 8 cases, intraductal papilloma in 5 cases, mammary cysts in 5 cases, catheter cystic dilatation with chronic inflammation in 1 case, cystic mammary gland disease in 3 cases）, malignant change of 36 patients （infiltrating ductal carcinoma in 28 cases, infiltrating lobular carcinoma in 3 cases, ductal carcinoma in situ in 2 cases, invasive papillary carcinoma in 2 cases, medullary carcinomas 1 case）. Malignant change much performed edge burr, sign of lobulation or edge blur, annular strengthen or irregular aggrandizement. Benign lesions much performed smooth edges and tidy uniform aggrandizement, of which 5 cases of cyst without aggrandizement. Shape of positive prediction was 89.47%, negative prediction was 90.00%, accuracy was 89. 66%. Strengthen performance： positive prediction was 89.74%, negative prediction was 94.74%, accuracy was 91.38%. Time-signal intensity curve, 22 cases benign lesions, 13 cases （59.09%） for type I , 8 cases （36.36%） for type Ⅱ , 1 cases （4.55%） for type Ⅲ ; 36 cases of malignant lesions, 1 case （2. 78%） for typeI , 9 （25.00%） cases for type Ⅱ , 26 cases （72.22%） for type Ⅲ , positive prediction was 79.55 % , negative prediction was 92.86 %, accuracy was 82.76%. Conclusion, It＇s very valuable for combining MR dynamic enhancement of breast morphological features with time-signal intensity curve in diagnosis and differential diagnosis of benign and malignant lesions.