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目的评价 MR 低信号分隔征在乳腺良、恶性肿瘤鉴别诊断中的价值。方法回顾性分析了经手术病理及临床随访证实的12例20个乳腺癌和14例25个纤维腺瘤的 MR 表现特点,分析低信号分隔征的鉴别诊断价值。结果乳腺癌和纤维腺瘤在 MR 抑脂 T_2WI 信号可为等、高信号,低信号,混杂信号,3种信号在乳腺癌分别为5、11、4个,在纤维腺瘤分别为11、10、4个,两者差异无统计学意义(χ~2=1.764,P=0.414)。病灶形状可分为不规则形、类圆形和分叶状,3种形状在乳腺癌和纤维腺瘤分别为12、7、1个和1、7、17个,差异有统计学意义(χ~2=23.262,P=0.000)。纤维腺瘤特征性表现分叶状、抑脂 T_2WI 及增强后低信号分隔征,诊断纤维腺瘤的敏感度分别为68%(17/25)、52%(13/25)、72%(18/25),特异度分别为95%(19/20)、90%(18/20)、95%(19/20)。结论低信号分隔征是诊断乳腺纤维腺瘤较特异的征象之一。
Objective To evaluate the value of MR signal separation in the differential diagnosis of benign and malignant breast tumors. Methods The MR manifestations of 12 cases of 20 breast carcinomas and 14 cases of 25 fibroadenomas confirmed by surgical pathology and clinical follow-up were retrospectively analyzed. The differential diagnostic value of low signal sign was analyzed. Results The breast cancer and fibroadenoma in MR fat-suppressed T_2WI signal can be equal, high signal, low signal, mixed signal, the three signals in breast cancer were 5,11,4, respectively, in fibroadenoma were 11,10 , 4, the difference was not statistically significant (χ ~ 2 = 1.764, P = 0.414). The shape of the lesion can be divided into irregular shape, round and lobulated, three kinds of shape in breast cancer and fibroadenoma were 12,7,1 and 1,7,17, the difference was statistically significant (χ ~ 2 = 23.262, P = 0.000). Fibroadenoma showed lobular, fat-suppressed T_2WI and enhanced low-signal sign, the sensitivity of fibroadenoma were 68% (17/25), 52% (13/25), 72% (18) / 25), specificity was 95% (19/20), 90% (18/20), 95% (19/20) respectively. Conclusion Low signal separation sign is one of the more specific signs of diagnosis of breast fibroadenoma.