摘要
目的探讨MRI对乳腺薄壁囊性病变良、恶性的鉴别诊断价值。方法回顾性分析2012年1月至2016年12月辽宁省肿瘤医院诊断经手术病理证实，MRI增强扫描表现为薄壁囊性病变的76例患者（81个病变）。患者均行双侧乳腺平扫及动态增强扫描。采用MRI乳腺影像报告和数据系统（BI-RADS）标准对MRI平扫及动态增强扫描图像进行分析，分析病变的边缘、内部强化特征及时间信号强度曲线（TIC）类型等特征，采用χ2检验比较良恶性病变间囊壁边缘、厚度、强化形式、是否存在壁结节及内部分隔的差异，采用Fisher法比较TIC曲线及壁结节位置的差异，采用独立样本t检验比较壁结节大小的差异。结果81个病灶中，良性病灶67个，恶性病灶14个。良性病灶中，56个囊壁清晰，58个囊壁厚度均匀，7个有壁结节；恶性病灶中，5个囊壁清晰，8个囊壁厚度均匀，9个有壁结节，良恶性病灶间上述特征的差异有统计学意义（P均〈0.05）。9个存在壁结节的恶性病灶中，7个壁结节位于壁外，1例壁结节位于壁间，1例壁结节位于壁内；7个存在壁结节的良性病灶中，4个位于壁间，1个位于壁内，2个位于壁外，良、恶性壁结节位置的差异有统计学意义（χ2=6.228，P=0.043）。良恶性病灶间均匀强化、内部分隔情况及壁结节大小的差异均无统计学意义（P均〉0.05）。9个良性病灶由于囊壁呈细线状强化，无法获得TIC曲线进行强化程度评价，对58个良性病灶和14个恶性病灶的TIC进行分析，良性病灶Ⅰ型及Ⅱ型TIC多见、恶性病灶Ⅱ型及Ⅲ型多见，TIC类型的差异有统计学意义（P〈0.05）；囊壁强化程度的差异无统计学意义（P〉0.05）。结论乳腺薄壁囊性病变多为良性病灶，囊壁强化特点联合TIC曲线有助于发现恶性病灶。
ObjectiveTo investigate the value of differential diagnosis of benign and malignant of breast cystic lesion with thin-wall in MRI.MethodsRetrospective analysis from January 2012 to December 2016 Liaoning Cancer Hospital diagnosis confirmed by surgery and pathology, and a total of 81 lesions （76 patients） of breast cystic lesions with thin-wall on MRI enhanced images （thickness no more than 5 mm, mural node less than 10 mm and solid position less than 50%）were enrolled. All patients underwent bilateral breast plain scan and dynamic contrast-enhanced scan. Using MRI breast imaging reporting and data system （BI-RADS） standard to analyze the MRI plain scan and dynamic contrast-enhanced scan images. Analysis of the margin of the lesion, internal enhancing features and time signal intensity curve （TIC） type and other characteristics. The feature of wall margin, thickness and enhancement form, mural nodules and internal septation morphological were analysed by Chi-square test. TIC type and wall nodule position were analysed by Fisher method. Wall nodule sizes were analysed by using independent sample t test.ResultsOf the 81 lesions, 67 were benign lesions and 14 were malignant. Among benign lesions, 56 were with well-defined margin, 58 were with uniform wall thickness and 7 were with mural nodule. Among malignant lesions, 5 were with well-defined margin, 8 were with uniform wall thickness and 9 were with mural nodule, which showed statistically significant difference between benign and malignant lesions （P〈0.05）. Of the 9 malignant lesions with wall nodules, 7 were located outside the wall, 1 between the wall, and 1 within the wall. Of the 7 benign lesions with wall nodules, 4 were located between the wall, 1 within the wall and 2 outside the wall,which were significant difference in the location of nodules between benign and malignant lesion （χ2=6.228,P=0.043）. There was no significant difference between benign and malignant lesions in the homogeneous enhancing, internal separations and wall nodule size （P〉0.05）. Nine lesions can not obtain TIC to analyse enhancement degree due to thin linear enhancement of cyst wall. Through the analysis of TIC type of 58 benign lesions and 14 malignant lesions,Type Ⅰ and type Ⅱ TIC were more commonly presented in benign lesions. Type Ⅱ and type Ⅲ were more commonly found in malignant lesions, and TIC types were statistically different （P〈0.05）. There was no significant difference in the degree of cystic wall enhancement （P〉0.05）.ConclusionMost of breast cystic lesion with thin-wall are benign lesion, cystic wall enhancement characteristics combined with time-signal intensity curve helps to find malignant lesion.
作者
贾宇
何翠菊
罗娅红
于韬
Jia Yu;He Cuiju;Luo Yahong;Yu Tao(Department of Radiology,Jinzhou Medical University Postgraduate Cultivation Base and Cancer Hospital of Liaoning Province,Shenyang 110042,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2018年第9期673-676,共4页
Chinese Journal of Radiology
基金
国家重点研发计划（2017YFC1309100）
关键词
乳腺肿瘤
囊性病变
磁共振成像
Breast neoplasms
Cystic lesion
Magnetic resonance imaging
