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目的探讨VIEWS磁共振动态增强技术在乳腺病变诊断中的价值。方法回顾分析已行MRI平扫及VIEWS技术动态增强连续5min 5期扫描检查并减影的78例经病理证实的乳腺病变患者,分析比较良、恶性病变的形态学特征、强化模式及时间信号强度曲线。结果 78例患者共101个病灶,其中恶性病变38例共60个病灶、良性40例共41个病灶。良性病变增强后多呈圆形、边缘光整、边界清楚、无毛刺,强化均匀;强化模式大多表现为逐渐强化。恶性病变形态不规则,边缘有毛刺或蟹足征;本组所有恶性病灶均表现为早期(1～2min内)明显强化。良恶性病变的时间-信号强度曲线表现不同,良性病变多呈Ⅰ型“持续型”(25/37),恶性病变多呈Ⅲ型“廓清型”(51/60),差异有统计学意义(χ2=55.2,P<0.001)。结论 VIEWS动态增强扫描有利于显示病变的形态学和血液动力学信息,对乳腺良恶性病变的诊断和鉴别诊断有重要意义。增强后第1分钟有利于观察病灶早期血供特征,第5分钟有利于观察肿瘤的边缘浸润特征及肿块内的结构。第1分钟明显强化、肿块不规则、边缘有毛刺或蟹足征、时间信号曲线呈廓清型是乳腺癌的特征性改变;各期减影图显示强化病灶更清晰、更直观。
Objective To explore the value of VIEWS magnetic resonance dynamic enhancement technique in the diagnosis of breast lesions. Methods Seventy-eight patients with pathologically confirmed breast lesions were retrospectively analyzed with MRI scans and VIEWS technique to dynamically enhance 5 min 5-phase scans and subtraction. The morphological features, enhancement patterns, and time signal intensity of benign and malignant lesions were analyzed and compared. curve. Results There were 101 lesions in 78 patients, including 38 lesions in 38 lesions and 41 lesions in 40 benign lesions. The enhancement of benign lesions was mostly round, with smooth edges, clear borders, no burrs, and enhanced uniformity; most of the enhancement patterns were gradually strengthened. Malignant lesions were irregular in shape, with burrs or crab foot marks on the edges; all malignant lesions in this group showed early enhancement (within 1-2 min). The time-signal intensity curves of benign and malignant lesions were different. The benign lesions were mostly type I “persistent type ” (25/37), and the malignant lesions were mostly type III “clear type ” (51/60). Statistical significance (χ2=55.2, P<0.001). Conclusion VIEWS dynamic enhanced scanning is helpful to display the morphological and hemodynamic information of lesions. It is of great significance for the diagnosis and differential diagnosis of benign and malignant breast lesions. The first minute of enhancement was helpful to observe the early blood supply characteristics of the lesion, and the first 5 minutes was conducive to observing the edge infiltration characteristics of the tumor and the structure within the tumor. Significant enhancement at 1 minute, irregular masses, burrs at the edges, or crab foot mark, and a clear time-type signal curve are characteristic features of breast cancer; subtraction images at each stage show that the enhanced lesions are clearer and more intuitive.