【摘要】 目的:探讨多层螺旋CT(MSCT)增强检查对乳腺疾病的鉴别诊断价值。方法:经手术病理证实的84位患者,共检出93例乳腺病变,其中浸润性导管癌57例,粘液癌4例,纤维腺瘤13例,导管内乳头状瘤4例,其他良性病变15例。CT检查先平扫,而后分别于静脉注射对比剂后28s、90s时进行二期增强扫描。对照手术病理结果,分析所有乳腺病变的CT表现。结果:乳腺良、恶性病变的平扫密度之间的差异无统计意义(P>0.05)。乳腺良、恶性病变的形状、边缘及强化形式之间的差异有统计意义(P=1.57×10-4;P=1.75×10-28;P=1.78×10-2)。以25HU为分界点,本组乳腺良、恶性病变动脉期强化程度之间的差别有高度统计意义(P<0.001)。MSCT诊断本组乳腺病变的敏感性为96.7%,特异性为90.6%,阳性预测值为95.2%,阴性预测值为93.5%。MSCT对61例乳腺癌腋窝淋巴结转移的术前检出率为88.8%。结论:多层螺旋CT增强检查在鉴别乳腺良恶性病变方面具有较高的诊断价值。更多还原

【Abstract】 Objective:To evaluate contrast enhancement of multi-slice helical CT in differentiating benign breast lesions from malignant breast lesions.Methods:The subject were 84 patients with 93 breast lesions confirmed by pathology, including invasive ductal carcinoma（n=57）,mucous carcinoma（n=4）,fibroadenoma（n=13）,intraductal papilloma（n=4） and other benign lesions（n=15）.Following plain CT scanning,two phases enhanced scanning was initiated respectively at 28 and 90 second after contrast agent injection.Compared with histopathologic results,the CT findings of all breast lesions were analyzed.Results:There was no statistical significant difference between malignant and benign group in the density of mass on non-contrast phase（P>0.05）.There was statistical difference between the benign and the malignant group in the shape,edge,and enhancement pattern of mass(P=1.57×10^-4;P=1.75×10^-28;P=1.78×10^-2).Regarding a lesion with an enhancement of 25HU or more on the arterial contrast phase as a criterion,there is a statistical significant difference between breast malignant and benign lesions（P<0.001）.MSCT had a sensitivity of 96.7%,a specificity of 90.6%,a positive predictive value of 95.2%,and a negative predictive value of 93.5% in differentiating between benign and malignant breast masses.88.8% axillary lymph node metastasis could be preoperatively detected by MSCT.Conclusion:Contrast enhancement of multi-slice helical CT is of great value in differentiating benign from malignant breast lesions.更多还原