乳腺疾病磁共振扫描方案的优化选择.pdfVIP

白 516 甲 磁共据新技术1临床应用 CLlNICAL APPLlCATION OF THE NEW MRI TEC~制阳UE 乳腺疾病磁共振扫描方案的优化选择 贯文霄 1 杨利霞 2 邵华 2 尚柳彤 2 何乐 2 [摘要}探H磁共振多种扫描序列及方法诊断乳腺良、恋性疾病的应用价值，旨在为临床确定最优磁共振乳腺扫 描H束。对 42 例乳腺挟捎患者分另IH1Hi磁片振平拙和动在增强扫描战部分 DWI ， DWIBS 检膏，与子术耐理结 果对照，分析各种方法战断价值及临床意义。多数呐灶在俄共报平扣克特征性价值，联合动态增强各项标准盼断 乳腺癌的敏感度为 95.8% ，特异度 87.99品，准确度为 9 1. 2% ，恶性组 ADC 值明报低于良性组，差异有统计学意 义 (P 0.05) ，以民oc 刷钱确定的诊断间值沟1. 542 X 10-3 mm21 8 0 以此值作为良、恶怜判断界值，敏感度 83.3% ，特异皮 85.7% ，珍断放果较好。 5 例 DWIBS 检蜜，观攘到淋巴结转移及病灶远处转移灶，敏感性很高， i革命乳腺多病变中心的观察及乳腺肿瘤的筛检和乳腺癌患者治疗前后的评估。时间 4 信号强度曲线、峰{商时间 及孕期增强卒， DWr 在鉴别乳腺良、恶性病变方面具布较高的敏感性和特异性， DWIBS 亦具有较高的敏感性， 结合各种扫描卉睹的良罪性评判标准，对良、感性病变的珍断及鉴别险断有最要价值，且优化11\临床最佳磁共振 乳腺扫描方案。 [关键诩} 乳腺疾病; 磁共振成像; 动态增强;DWI;DWIBS 中圈分提号: R814 .4 文献标识码 :A 文章编号: 1006 - 5741 (2008) 曰… 0516- 07 Better Selection Scan Ways in MRI of the Breast Lesions JIA Wen- Xíad , YANG Li- Xüt , SHAO Hucf , et αl {Abstract] To 叫lore the better selection s侧 ways of MRl in the 伽gnosis of in breast lesions. 42 cases of breast disease patíents underwent MRI with fast spin echo(川剧， 3D dynamíc contrast - en- hanced , DWI , DWIBS. Among the to时， 33 c闹剧 were benign lesions , 24 were malígnant lesions with postoperative pathology or bi叩sy confirmed. The enhancement of morphological characteristi饵， the dy唰 namíc parameters , including time …signal íntensíty curve type , time to peak and early enhanced rate were analyzed.DWI w拙 done with single shot SE EPI sequence , b = Os/rnnr ， 30伽1m时 ， 500s/m时 ， 80051 rnnr I 1000s/m时 .Combining of dynamic 5canning , the 5ensitívity is 95. 8% , the specíficíty is 87.9% and the accuracy is 91. 2 % for detection of breast 崎ncer. The threshold between malignant and benign le- sions w制1. 542 x 1O-3mm21 s according to ROC(receiver operator characteristic curve) . The 日ensitivity and specificity for the threshold were83. 3%and 85.7% , respectively . Time … sígnal intensíty curve I the peak time and the rate of increase have hígher sensítivity and specificíty in early identification of benign and malignant breast disease. Wit