中国临床医学影像杂志
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多模态MRI技术在乳腺非肿块性强化病变良恶性鉴别中的临床研究
刘  靓,朱  丹,沈  晶,伍建林
大连大学附属中山医院放射科,辽宁 大连  116011
Clinical study of multi-mode MRI in differentiating benign and malignant breast non-mass-like enhancement lesions
LIU Liang, ZHU Dan, SHEN Jing, WU Jian-lin
Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning 116011, China
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摘要 目的:探讨多模态3.0T MRI技术在乳腺非肿块性强化病变(NMLE)良恶性鉴别诊断中的效能与临床应用价值。方法:回顾性分析在本院经手术和病理学证实且均行3.0T MRI检查的90例乳腺NMLE患者资料,其中良性病变31例(良性组),恶性病变59例(恶性组),均为女性,平均年龄(46.3±9.1)岁。分析比较两组NMLE分布类型及在DCE-MRI上的强化特点与时间-信号强度曲线,在DWI上检测与确定ADC最佳阈值及诊断敏感度与特异度。结果:①分布类型:导管型、节段型、区域型和弥漫型,其中节段型分布两组间差异有统计学意义(P<0.05),其余者差异无统计学意义(P>0.05);②强化病变特点:均匀、不均匀、集丛样强化、簇样环形强化,其中集丛样强化在两组间差异具有统计学意义(P<0.05),其余差异无统计学意义(P>0.05);③时间-信号强度曲线类型在两组间差异不具有统计学意义(P>0.05)。④ADC值:两组平均ADC值分别为(1.11±0.32)×10-3 mm2/s、(1.47±0.37)×10-3 mm2/s,差异有统计学意义(P<0.05),ADC值≤1.3×10-3 mm2/s诊断NMLE为恶性病变的敏感度与特异度为71.8%、78.8%。结论:应用DCE-MRI与ADC值测量提供的形态学与功能学信息有助于提高乳腺NMLE良恶性病变的诊断效能。
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关键词 乳腺疾病乳腺肿瘤磁共振成像    
Abstract:Objective: To explore the efficacy and clinical value of multi-mode 3.0T MRI in the differential diagnosis of benign and malignant breast non-mass-like enhancement(NMLE) lesions. Methods: The data of 90 cases of breast NMLE lesions confirmed by operation and pathology and examined by 3.0T MRI were analyzed retrospectively. Among them, 31 cases were benign lesions(benign group) and 59 cases were malignant lesions(malignant group), all of them were female. Average age was 46.3±9.1. The distribution types, enhancement characteristics and time-intensity curve(TIC) on DCE-MRI were analyzed and compared between the two groups. The optimal threshold, diagnostic sensitivity and specificity of ADC were detected and determined on DWI. Results: ①Distribution type: dutcal type, segmental type, regional type and diffusive type, among which, the difference of segmental type distribution between the two groups was statistically significant(P<0.05), while the difference of the rest was not statistically significant(P>0.05);②Characteristic of enhanced lesions: the homogeneous, the heterogeneous, the clumped and the clustered ring. The clumped enhancement in the two groups had statistical significance(P<0.05), and the remaining variances were not statistically significant(P>0.05); ③The types of TIC in the two groups were not statistically significant(P>0.05); ④ADC value: The average ADC values of the two groups were (1.11±0.32)×10-3 mm2/s, (1.47±0.37)×10-3 mm2/s, and the difference was statistically significant(P<0.05), When the ADC value was less than or equal to 1.3×10-3 mm2/s, the sensitivity and specificity of diagnosing NMLE lesions as malignant lesions was 71.8% and 78.8% respectively. Conclusion: The application of DCE-MRI and ADC value measurement provides morphological and functional information that is helpful to distinguish benign and malignant breast NMLE lesions.
Key wordsBreast diseases    Breast neoplasms    Magnetic resonance imaging
收稿日期: 2019-03-04     
PACS:  R655.8  
  R737.9  
  R445.2  
通讯作者: 伍建林,大连大学附属中山医院放射科,116011。E-mail:cjr.wujianlin@vip.163.com   
作者简介: 刘靓(1986-),女,辽宁海城人,主治医师。E-mail:sunny-lliang@163.com
引用本文:   
刘 靓,朱 丹,沈 晶,伍建林. 多模态MRI技术在乳腺非肿块性强化病变良恶性鉴别中的临床研究[J]. 中国临床医学影像杂志, 2020, 31(1): 15-19.
LIU Liang, ZHU Dan, SHEN Jing, WU Jian-lin. Clinical study of multi-mode MRI in differentiating benign and malignant breast non-mass-like enhancement lesions. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(1): 15-19.
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http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.01.004     或     http://www.jccmi.com.cn/CN/Y2020/V31/I1/15
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