CAJ | 학술논문

目的：探讨动态增强核磁共振成像( MRI)在乳腺良恶性疾病鉴别诊断中的价值。方法回顾性分析自2012年1月至2014年6月经病理证实的乳腺占位性病变70例(78乳)患者的MRI资料,其中乳腺癌46乳,良性占位32乳,观察良恶性乳腺病变的MRI征象及强化参数,比较MRI动态增强扫描与MRI平扫诊断乳腺癌的特异度、灵敏度及准确性。结果①良性病变患者平均年龄显著低于恶性病变患者(t=8.225,P<0.05),乳腺恶性病变不均匀性分布较良性病变显著升高(χ2=11.287,P<0.05),乳腺良恶性病变MRI平扫显示率、T1WI与T2WI信号强度分布比较差异无统计学意义(χ2值分别为4.126、3.855、5.362,均P>0.05)；②乳腺恶性病变峰值增强率(Emax)显著高于良性肿块,峰值时间(Tmax)、最大强化速率(Slopemax)显著低于良性病变(t值分别为10.286、11.445、7.236,均P<0.05)；③乳腺恶性病变SI-Time曲线廓清型、平台型、渐进型分别为38例、6例、2例,良性病变分别为0例、5例、27例,两组比较SI-Time曲线类型分布差异有统计学意义(χ2=10.381,P<0.05)；④MRI动态增强扫描检查乳腺恶性病变灵敏度、特异度及准确率分别为100%、96.88%、98.72%,均高于 MRI 平扫的78.26%、78.13%、78.20%,比较差异有统计学意义(χ2值分别为7.382、8.164、8.237,均P<0.05)。结论乳腺良恶性疾病动态增强MRI扫描具有特异性表现,具有较高的鉴别诊断参考价值。
목적：탐토동태증강핵자공진성상( MRI)재유선량악성질병감별진단중적개치。방법회고성분석자2012년1월지2014년6월경병리증실적유선점위성병변70례(78유)환자적MRI자료,기중유선암46유,량성점위32유,관찰량악성유선병변적MRI정상급강화삼수,비교MRI동태증강소묘여MRI평소진단유선암적특이도、령민도급준학성。결과①량성병변환자평균년령현저저우악성병변환자(t=8.225,P<0.05),유선악성병변불균균성분포교량성병변현저승고(χ2=11.287,P<0.05),유선량악성병변MRI평소현시솔、T1WI여T2WI신호강도분포비교차이무통계학의의(χ2치분별위4.126、3.855、5.362,균P>0.05)；②유선악성병변봉치증강솔(Emax)현저고우량성종괴,봉치시간(Tmax)、최대강화속솔(Slopemax)현저저우량성병변(t치분별위10.286、11.445、7.236,균P<0.05)；③유선악성병변SI-Time곡선곽청형、평태형、점진형분별위38례、6례、2례,량성병변분별위0례、5례、27례,량조비교SI-Time곡선류형분포차이유통계학의의(χ2=10.381,P<0.05)；④MRI동태증강소묘검사유선악성병변령민도、특이도급준학솔분별위100%、96.88%、98.72%,균고우 MRI 평소적78.26%、78.13%、78.20%,비교차이유통계학의의(χ2치분별위7.382、8.164、8.237,균P<0.05)。결론유선량악성질병동태증강MRI소묘구유특이성표현,구유교고적감별진단삼고개치。
Objective To explore the value of dynamic contrast-enhanced MRI in the differential diagnosis of benign and malignant breast diseases. Methods Retrospective analysis was conducted on MRI data of 70 cases (78 breasts) with breast lesions confirmed pathologically during the period of January 2012 to June 2014, including 46 breasts of carcinoma and 32 breasts of benign diseases. MRI signs and enhanced parameters of benign and malignant breast lesions were observed, and specificity, sensitivity and accuracy were compared between dynamic contrast-enhanced MRI scan and MRI plain scan in diagnosis of breast cancer. Results The average age of patients with benign lesions was significantly lower (t=8. 225, P<0. 05), and the uneven distribution of malignant breast lesions was significantly higher than benign lesions (χ2 =11. 287, P<0. 05). There were no significant differences in MRI plain scan display rate, distribution of T1WI and T2WI signal intensity (χ2 value was 4. 126, 3. 855 and 5. 362, respectively, all P>0. 05). Emax of malignant breast lesions was significantly higher than benign tumors, but Tmax and Slopemax were significantly lower than benign lesions ( t value was 10. 286, 11. 445 and 7. 236, all P<0. 05). There were 38 cases, 6 cases and 2 cases of SI-Time curve clearance type, platform type and progressive type, respectively in malignant lesions, and there were 0 case, 5 cases and 27 cases in benign lesions. The difference in distribution of SI-Time curve between two groups was significant (χ2 =10. 381, P<0. 05). The sensitivity, specificity and accuracy of dynamic contrast-enhanced MRI scan for malignant lesions was 100%, 96. 88% and 98. 72%, respectively, which were higher than those of MRI plain scan (78. 26%, 78. 13%, 78. 20%), and the differences were statistically significant (χ2 value was 7. 382, 8. 164 and 8. 237, respectively, all P<0. 05). Conclusion Benign and malignant breast diseases have specific signs in dynamic contrast-enhanced MRI scan, so dynamic contrast-enhanced MRI scan has high differential diagnosis value.