【摘要】 目的:探讨磁共振动态增强平台型时间-信号曲线(time-signal intensity curves,TIC)在诊断乳腺良、恶性病变中的应用价值。方法:分析39例磁共振动态增强扫描后时间-信号强度曲线呈II型平台型患者的磁共振表现。检查采用飞利浦Achieva1.5T磁共振成像系统,图像后处理在飞利浦工作站上使用软件。扫描序列包括轴面DWI、T1WI,轴面反转恢复脂肪抑制(STIR)T2WI,及静脉注射造影剂后三维动态增强扫描(DCE-MRI)。对于乳腺出现异常强化病灶层面绘制TIC曲线,并对时间-信号曲线II型的病例进行分析。结果:时间-信号曲线为II型经病理检查证实的共39例病例中,左乳21例、右乳18例。良性病变21例(54%),其中乳腺腺病3例、乳腺纤维腺瘤18例。恶性病变18例(46%),其中原位癌1、例髓样癌4例、浸润性导管癌13例、良性乳腺病变中II型曲线最多见于乳腺纤维腺瘤,恶性病变最多见于乳腺浸润性导管癌。II型曲线诊断乳腺恶性肿瘤的灵敏度为83.33%、特异度为42.86%、阳性预测值为55.56%、阴性预测值为75.00%。结论:乳腺良、恶性病变经磁共振增强扫描后均可表现为II型曲线,对此类病变进行诊断需要结合患者病史、病变形态学、BI-RADS-MRI分级及增强扫描后成像参数等综合分析。更多还原

【Abstract】 Objective:To explore the value of time-signal intensity curve(TIC)type II in identifying enhanced lesions of the breasts on dynamic contrast-enhanced MRI(DCE-MRI),to provide a more reliable evidence for clinical work. Materials and methods: 39 patients with breast lesions performed MRI examinations at 1.5 T scanner. Numbers and features of the lesions were analyzed on axial FSE T1WI, axial STIR T2WI, and 3-dimentional DCE-MRI after intravenous gadolinium administration. TIC types of the enhanced lesions were classified according to their shapes. Pick out type II to analysis. Results: Among39 female patients, the left breasts21,the right breasts 18,abnormally enhanced lesions with TIC type II on DCE-MRI included Benign lesions in 21(54%),(Breast adenosis 3, Breast fibroadenoma 18), Malignant lesions in 18(Ductal carcinoma in situ 1, Medullary carcinoma 4,Invasive ductal carcinoma 13). TIC type II to judge the malignant and benign breast disease, sensitivity was 88.33%, specificity 42.86%,positive predictive value 55.56%,negative predictive value75.00%.Conclusion: TIC type I may be found in both benign and malignant lesions of the breasts, it is necessary to combine with clinical history and MRI morphological characteristics, BI-RADS-MRI degree, after the enhanced scan data for a correct judgment to breast disease.更多还原