摘要
目的:探讨3.0T MR动态增强扫描在鉴别乳腺导管原位癌和乳腺腺病中的价值。方法:研究纳入了经手术或穿刺活检证实的38例导管原位癌和40例乳腺腺病患者,对两组病变的MR多期动态增强表现进行回顾性对照分析,评价指标包括:强化形态、内部强化特点及时间-信号强度曲线,并对有统计学显著性差异的影像学征象的鉴别诊断价值进行分析。结果:导管样强化、节段样强化和肿块样强化多见于导管原位癌(P=0.04,0.04,0.02)。区域性强化和弥漫性强化多见于乳腺腺病(P=0.03,0.02)。点簇样强化及边缘强化多见于导管原位癌(P=0.02,0.03)。不均匀性强化多见于乳腺腺病(P=0.04)。速升缓降型曲线和速升平台型曲线多见于导管原位癌(P=0.03,0.02),持续缓升型和缓升平台型多见于腺病(P=0.03,0.04)。病变强化形态的鉴别诊断价值要高于内部强化特点和时间-信号强度曲线,其敏感度、特异度及准确度分别为69.2%、71.2%和70.4%。结论:3.0T MR动态增强扫描有助于鉴别导管原位癌和乳腺腺病,病变强化形态的鉴别诊断价值要高于内部强化特点和时间-信号强度曲线。
Objective： To investigate the value of dynamic contrast - enhanced imaging at 3.0T MR examination in differentiation between ductal carcinoma in situ（DCIS） and adenosis of the breast. Methods：This study included 38 cases of DCIS and 40 cases of adenosis confirmed with surgery or biopsy. These patients underwent dynamic contrast - enhanced MR examination. The dynamic contrast - enhanced MR manifestations, including enhancement morpholo- gy, internal enhancement characteristics and time -intensity curve（ TIC）, were retrospectively compared between two groups. For the imaging features which had statistical differences, the differentiation diagnostic values were analyzed. Results： Ductal, segmental and masslike enhancement patterns were mostly seen in DCIS（ P = 0.04,0.04,0.02 ）, re- gional and diffuse enhancement patterns were mostly seen in adenosis（P =0.03,0.02）. Clumped nodular and periph- eral enhancement patterns were frequently seen in DCIS（ P = 0.02,0.03 ）, and heterogeneous enhancement was fre- quently seen in adenosis （P = 0.04 ）. TIC showing a rapid rise followed by a slow decline and TIC showing a rapid rise followed by a plateau were frequently seen in DCIS （P = 0.03,0.02 ） , TIC showing persistent slow rise, TIC showing a slow rise followed by a plateau were frequently seen in adenosis（ P = 0. 03 ,0. 04.） . The differential diagnostic value of enhancement morphology was higher than that of internal enhancement characteristics or time - intensity curve, and differentiation diagnostic sensitivity, specificity and accuracy of enhancement morphology was 69.2% ,71.2% and 70.4% respectively. Conclusion： Dynamic contrast - enhanced imaging at 3.0T MR examination is helpful for differ- entiation between DCIS and adenosis, the value of enhancement morphology in differential diagnosis is higher than that of internal enhancement characteristics or time - intensity curve.
出处
《现代肿瘤医学》
CAS
2015年第3期395-399,共5页
Journal of Modern Oncology
关键词
乳腺
导管原位癌
腺病
磁共振成像
动态增强
breast
ductal carcinoma in situ （I）CIS）
adenosis
magnetic resonance imaging
dynamic contrast en-hancement
