目的:了解多层螺旋CT动态增强扫描对乳腺良恶性病变诊断的价值。方法:42例45个病灶,其中乳腺癌病灶22个,乳腺良性病变23个(乳腺炎9个,乳腺纤维瘤4个,乳腺增生性疾病10个),行多层螺旋CT扫描平扫,并于增强后60、120、180、300、480 s进行多期增强扫描。结果:(1)CT表现:乳腺癌多为不规则肿块,伴分叶、毛刺及周围浸润的表现;明显不均匀强化。乳腺炎为乳腺密度增高,边缘模糊,多无明确肿块,伴有邻近皮肤增厚,皮下脂肪层混浊,多明显强化。乳腺纤维瘤为等密度、边界清、轮廓光整肿块,均匀强化。乳腺增生性疾病呈腺体增厚,增强为多发或弥漫性分布的强化灶,强化弱且不均匀。(2)时间密度曲线(TDC):乳腺癌和乳腺炎呈速进速退型,乳腺纤维腺瘤表现为持续上升型,乳腺增生性疾病表现为缓慢上升型。(3)各组病灶平扫CT值差异无统计学意义,增强后延迟60 s和120 s时乳腺增生组CT值增强幅度△CT值与乳腺炎和乳腺癌的△CT值差别有统计学意义(P<0.05);延迟180、300、480 s时纤维腺瘤的△CT值与乳腺炎、乳腺癌和乳腺增生组的△CT值差别有统计学意义(P<0.05)。结论:多层螺旋CT动态增强扫描对乳腺疾病具有重要的诊断和鉴别价值。 Objective: To investigate the value of dynamic contrast-enhanced multislice spiral CT in the diagnosis of benign and malignant breast lesions. Methods: 42 lesions (45 lesions), including 22 breast lesions and 23 benign breast lesions (9 mastitis, 4 breast fibroids and 10 breast hyperplasia lesions) underwent multi-slice spiral CT scan. After the enhancement 60,120,180,300,480 s for multi-phase enhanced scan. Results: (1) CT: breast cancer mostly irregular mass, with lobulation, burr and the surrounding infiltration of performance; significantly uneven enhancement. Mastitis is increased breast density, blurred edges, no clear mass more, accompanied by thickening of the adjacent skin, subcutaneous fat layer of opacity, and more significantly enhanced. Breast fibroids are isosceles, border clear, contour light whole mass, uniform enhancement. Hyperplastic breast disease was glandular thickening, enhanced to multiple or diffuse distribution of enhanced focus, strengthen the weak and uneven. (2) Time-density curve (TDC): Breast cancer and mastitis showed rapid retreat, breast fibroadenoma showed persistent type, and mammary gland hyperplasia manifested as slow-rising type. (3) There was no significant difference in the CT value of CT scan between the two groups. After the enhancement of 60 s and 120 s, the △ CT value of CT value and the △ CT value of mastitis and breast cancer were significantly different (P <0.05). The △ CT value of fibroadenoma was significantly different from that of mastitis, breast cancer and breast hyperplasia group at 180,300 and 480 s (P <0.05). Conclusion: Multi-slice spiral CT dynamic enhanced scan has important diagnostic and differential value for breast disease.