3D T1WI动态增强成像诊断乳腺良恶性病变的价值

目的:评价T1WI动态增强成像在鉴别乳腺良恶性肿瘤方面的诊断价值。方法:54例乳腺疾病患者的59个病灶经T1WI动态增强成像,分析每个病灶的强化曲线类型、定量分析T1WI动态增强的早期强化率和达到强化峰值的时间,进行统计学处理。结果:应用T1WI动态增强成像序列,良、恶性病变的时间-信号强度曲线的分布有特异性,良性病变多为I、II型,恶性病变多为IV、V型,表现为III型曲线的病灶大部分为恶性病灶,少部分为良性病灶;信号强度增加率之间差异有显著性意义(t=2.563,P=0.015),但两者的早期增强程度范围有很大的重叠,敏感性为89.1%,特异性仅为30.7%;良、恶性病变增强信号达到峰值时间的差异有非常显著性意义(t=3.450,P=0.000),且二者之间重叠很少,诊断的敏感性为93.4%,特异性为69.2%。结论:T1WI动态增强的强化曲线类型、早期强化率在鉴别良恶性乳腺肿瘤方面有较高的敏感性,但特异性较差,病灶强化的峰值时间在乳腺肿瘤的良恶性鉴别方面具有较高的敏感性和特异性,可以提高乳腺MR成像诊断的准确性,减少组织穿刺活检率。

The value of 3D T1-weighted MR imaging in the diagnosis of benign and malignant breast lesions

Objective: To evaluate 3D T1-weighted MR dynamic enhanced MRI find ings and their diagnostic value in benign and malignant breast lesions. Methods: The contrast-enhanced T1-weighted MR scanning was performed in 59 patients with breast neoplasms. SI changes during dynamic scanning, time-SI curve of the neop lasm, early-phase enhancement rate and the time of the highest mean enhancement amplitude were assessed. Results: With dynamic contrast-enhanced imaging, there was a significant difference in time-SI curve of the neoplasm and early-phase en hancement rate between the benign and malignant breast neoplasm, but a considera ble overlap of signal intensity increase between carcinomas and benign lesions w as found. There was a very significant difference in the time of the mean enhanc ement amplitude, with a sensitivity of 85% and specificity of 71%. And the overl ap was less than that of time-SI curve of the lesions and early-phase enhancemen t rate. Conclusion: The time-SI curve and early-phase enhancement rate of the ne oplasm has the higher sensitivity and lower specificity, the time of mean enhanc ement amplitude may improve the accuracy of diagnosis in breast lesions.