CAJ | 학술논문

目的探讨乳腺磁共振动态增强扫描多时相减影技术在乳腺肿瘤中的应用价值.方法回顾性分析2009年3月至2012年2月在南京医科大学第二附属医院放射科72例经手术病理证实为乳腺肿瘤患者的影像学资料,所有患者术前均行数字化乳腺摄影.MRI动态增强扫描(DCE-MRI),在注射对比剂前行蒙片3D mask扫描,注射对比剂同时开始连续采集9个时相,绘制时间-信号强度曲线(TIC),并分别选择动态增强的第1和第2时相图像与蒙片进行减影,后行最大信号强度投影(MIP)重建,对比两个时相的减影图像,MIP图像及动态增强图像,分析其对病灶及肿瘤血管的显示与定性价值.应用x2检验对乳腺良恶性肿瘤分别进行统计学分析.结果 72例患者共检出83个病灶,手术证实为83个病灶.其中纤维腺瘤18例,共检出23个病灶,均未见肿瘤血管,动态增强第1及第2时相减影对病灶的显示差异无统计学意义；导管内乳头状瘤4例,其中仅1例伴导管内癌者,可见肿瘤血管显示；本组良性肿瘤第1与第2时相减影对病灶的检出无明显差异.导管内癌5例,其中1例可见细小迂曲的肿瘤血管；45例浸润性导管癌均可见肿瘤血管,37例为多支肿瘤血管,8例为单支肿瘤血管,共发现51个病灶；第1时相减影,检出36个病灶,第2时相减影检出51个病灶,两者差异有统计学意义.结论良性肿瘤动态增强不同时相减影对病灶检出差异无统计学意义,而恶性肿瘤不同时相减影对病灶检出差异有统计学意义,结合TIC曲线进行多时相减影重建对于病灶检出及肿瘤血管的显示有重要意义.
목적 탐토유선자공진동태증강소묘다시상감영기술재유선종류중적응용개치.방법 회고성분석2009년3월지2012년2월재남경의과대학제이부속의원방사과72례경수술병리증실위유선종류환자적영상학자료,소유환자술전균행수자화유선섭영.MRI동태증강소묘(DCE-MRI),재주사대비제전행몽편3D mask소묘,주사대비제동시개시련속채집9개시상,회제시간-신호강도곡선(TIC),병분별선택동태증강적제1화제2시상도상여몽편진행감영,후행최대신호강도투영(MIP)중건,대비량개시상적감영도상,MIP도상급동태증강도상,분석기대병조급종류혈관적현시여정성개치.응용x2검험대유선량악성종류분별진행통계학분석.결과 72례환자공검출83개병조,수술증실위83개병조.기중섬유선류18례,공검출23개병조,균미견종류혈관,동태증강제1급제2시상감영대병조적현시차이무통계학의의；도관내유두상류4례,기중부1례반도관내암자,가견종류혈관현시；본조량성종류제1여제2시상감영대병조적검출무명현차이.도관내암5례,기중1례가견세소우곡적종류혈관；45례침윤성도관암균가견종류혈관,37례위다지종류혈관,8례위단지종류혈관,공발현51개병조；제1시상감영,검출36개병조,제2시상감영검출51개병조,량자차이유통계학의의.결론 량성종류동태증강불동시상감영대병조검출차이무통계학의의,이악성종류불동시상감영대병조검출차이유통계학의의,결합TIC곡선진행다시상감영중건대우병조검출급종류혈관적현시유중요의의.
Objective To evaluate the application value of multiple phase subtraction imaging of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in common breast tumor.Methods All radiographic and MRI data of 72 patients with histological proved common breast tumor were analyzed retrospectively.Prior to an injection of gadolinium-diethylenetriaminepentaacetate (GD-DTPA),3D mask scans were performed.Then 9 consecutive phases of imaging were acquired.After the drawing of time-signal intensity curve,he first and second phases were selected to perform subtraction with the mask,rebuild 3D maximum intensity projection and analyze the application value of subtracted and 3D maximum intensity projection (MIP) reformation images.Chi-square test was used for the analyses of benign and malignant breast tumors.Results There were 83 lesions in 72 patients.Among 18 cases of fibro adenoma,23 lesions had no tumor vessel.For the detecting ratio of lesions,the first and second phase subtraction imaging had no statistics difference.Only one intraductal papilloma with ductal carcinoma in situ (DCIS) had tumor vessel in 4 intraductal papilloma patients.Among 5 DCIS cases,one of them had small curved tumor vessel.And 51 lesions were found in 45 infiltrating ductal carcinoma (IDC) cases.Tumor vessels could be seen in all IDC cases.And 37 cases had multiple tumor vessels while 8 cases had single tumor vessel.When the first phase was used for subtraction,36 lesions were found.On the other hand,51 lesions were found in the second phase subtraction.There were significant differences between them.Conclusion No significant differences exist in benign breast tumor on differential phase subtraction images of DCE-MRI,but there are significant differences in malignant breast tumor.It is very important to detect the lesions and show the tumor vessels by rebuilding multiple phase subtraction.