MRI多参数分析在乳腺良、恶性病变诊断中的应用

目的探讨MRI多参数分析在乳腺良、恶性病变诊断中的应用。方法对44例乳腺疾病患者均行双乳T1WI、T2WI压脂扫描以及弥散加权成像（DWI）扫描。采用乳腺容积成像序列进行动态增强扫描。使用Functool软件进行表观弥散系数（ADC值）的测量、建立时间-信号强度增强曲线及计算出最大信号增加斜率（MSI）。结果 44例患者中,恶性25例,良性19例。其分叶及毛刺的敏感性、特异性、阳性预测值、阴性预测值以及准确度为62.5%～80.0%。时间-信号强度增强曲线显示：Ⅰ型曲线（平台型）17例,均为良性。Ⅲ型曲线（速升速降型）18例,均为恶性;其阳性预测值为100.0%,准确度为100.0%。Ⅱ型曲线（平台型或速升速降型）9例,其中良性2例,恶性7例。ADC值的敏感性为88.0%、特异性为84.2%、阳性预测值为88.0%、阴性预测值为84.2%、准确度为88.0%,各项指标均较高。MSI的敏感性为100.0%、特异性为100.0%、阳性预测值为100.0%、阴性预测值为90.5%、准确度为100.0%。结论乳腺疾病的MRI检查主要以形态学及动态增强后强化程度与方式评价为基础。时间-信号增强曲线、DWI及ADC值等对乳腺良、恶性病变的诊断有重要价值。

The Application of Breast Benign and Malignant Lesions Diagnosis with MRI Multiple Parametric Analysis

Objective To explore the application of MRI multiple parametric analysis in diagnosis of breast benign and malignant lesions.Methods 44 cases patient of breast disease all received double-breast axial T1WI,T2WI series,axial fat-pressure series and axial diffusion weighted imaging（DWI） scan.Using volume imaging for breast assessment series proceed dynamic contrast-enhanced scan.Using Functool software to obtain the measurement of Apparent Diffusion Coefficient（ADC value）,time-signal strength curves as well as maximum slope to increase（MSI）.Results In all 44 cases,including 25 malignant,19 benign.The sub-leaf and burr of the breast lesions had 62.5% to 80.0% sensitivity,specificity,positive predictive value,negative predictive value and accuracy.Time-signal intensity curve area：Ⅰtype curve as a platform type,all 17 cases are benign,Ⅲ type curve as a ascensus and downhill speed type,18 cases in this group are all malignant,the positive predictive value is 100.0%,accuracy is 100.0%,Ⅱtype curve as a platform type or ascensus and downhill speed type,9 cases in this group with 2 benign and 7 malignant.ADC value with sensitivity of 88.0%、specificity of 84.2%、positive predictive value of 88.0%、negative predictive value of 84.2%,and accuracy of 88.0%,are all higher index.Maximum Slope to Increase（MSI） had sensitivity of 100.0%、specificity of 100.0%、positive predictive value of 100.0%、negative predictive value of 90.5% and accuracy of 100.0%.Conclusion MRI examination of the mammary gland disease mainly based on morphology and the evaluation of reinforcement level and style after dynamic enhancement.Time-signal enhancement curve,DWI and ADC values has important value in the diagnosis of breast benign and malignant lesions.