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目的:探讨DCE-MRI在乳腺肿块性病变的诊断价值及病生基础。方法:回顾性分析经手术病理证实的乳腺肿块性病变38例,术前接受了乳腺MRI动态增强检查,分析病变的形态学及血流动力学改变。结果:38例病变,恶性25例,环形强化或边缘强18例,占72%;64%(16/25)边缘见毛刺,28%(7/25)形态不规则;早期增强率为(89.5±26.7)%;时间-信号强度曲线72%(18/25)为流出型,24%(6/25)为平台型。良性13例,38.5%(5/13)见分叶,46.2%(6/13)光滑;早期增强率为(51.5±22.3)%,76.9%(10/13)为流入型,15.4%(2/13)为平台型;良恶性病变增强形态、早期增强率和时间-信号强度曲线差异有显著性意义(P均<0.01);三者对良恶性病灶诊断的敏感性、特异性分别为92%(23/25)、84.6%(11/13);88%(22/25)、53.8%(7/13);96%(24/25)、76.9%(10/13)。结论:环形或边缘强化、毛刺状形态和流出型时间-信号强度曲线均强烈提示恶性;边缘光滑和单相型时间-信号强度曲线均强烈提示良性;早期增强率诊断的特异性较差。
Objective: To investigate the diagnostic value of DCE-MRI in breast lesions and the basis of disease patients. Methods: Thirty-eight cases of breast lesions confirmed by surgery and pathology were retrospectively analyzed. The dynamic MRI examination of breast was performed preoperatively to analyze the morphological and hemodynamic changes of the lesions. Results: There were 38 lesions and 25 malignant lesions, of which 18 were ring enhanced or marginal, accounting for 72%. Burr was seen on 64% (16/25) margins and 28% (7/25) were irregular. The early enhancement rate was 89.5 ± 26.7)%. The time-signal intensity curve was out of 72% (18/25) and platform type 24% (6/25). Benign in 13 cases, 38.5% (5/13) seen in the lobes, 46.2% (6/13) were smooth; the early enhancement rate was (51.5 ± 22.3)%, 76.9% / 13) were platform type. The benign and malignant lesions enhanced morphology, the early enhancement rate and the time-signal intensity curve had significant difference (all P <0.01). The sensitivity and specificity of the three in the diagnosis of benign and malignant lesions were 92 % (23/25), 84.6% (11/13); 88% (22/25), 53.8% (7/13); 96% (24/25), 76.9% (10/13). Conclusions: Circumferential or marginal enhancement, burr-like morphology and outflow time-signal intensity curves are strongly suggestive of malignancy; both marginal smooth and single-phase time-signal intensity curves are strongly suggestive of benignity; diagnosis of early enhancement rate is poorly specific.