3.0动态增强MR血管成像对乳腺良恶性病变的诊断价值-东南大学学报医学版

3.0动态增强MR血管成像对乳腺良恶性病变的诊断价值

单位：东南大学附属中大医院放射科, 江苏南京 210009

关键词：乳腺磁共振成像增强磁共振成像磁共振血管成像患侧血管增加病灶邻近血管最大信号投影

分类号：R737.9;R814.49

出版年·卷·期（页码）：2013·32·第四期（389-393）

摘要：

目的: 回顾性评估3.0T动态增强MR血管成像(MRA)对乳腺良恶性病变的诊断价值。方法: 经病理证实的108例乳腺疾病患者(52例恶性,56例良性)作为研究对象,借助3D MRA图像计算患侧血管增加(双侧差异血管数≥2)及病变邻近血管数。结果: 52例乳腺恶性病变中41例、56例良性病变中9例出现患侧血管增加,以患侧血管增加作为诊断标准,其对乳腺恶性病变诊断的敏感性、特异性及准确度分别79%、84%及84%;52例乳腺恶性病变中46例、56例良性病变中18例出现病灶邻近血管,以病灶邻近血管作为诊断标准,其对乳腺恶性病变诊断的敏感性、特异性及准确度分别为89%、68%及76%;患侧血管增加的阳性预测值及阴性预测值分别为82%、81%,病灶邻近血管的阳性预测值及阴性预测值分别为82%、79%。 结论: 3D MRA能有效评估双侧乳腺血管形成。乳腺恶性病变比良性病变更容易出现患侧血管增加及病灶邻近血管。

Objective: To retrospectively assess the use of 3.0 T contrast-enhanced MR angiography(MRA) in differentiating benign from malignant breast lesions.Materials and Methods: This retrospective study enrolled total of 108 patients with unilateral and histopathologically confirmed breast lesions (52 malignant lesions and 56 benign lesions) which were evaluated for ipsilateral increased vascularity and the presence of adjacent vessel sign by contrast-enhanced 3D MR angiograms.Results: Forty-one out of 52 patients with breast cancer and 9 out of 56 patients with benign lesions, ipsilateral increased breast vascularity was found. The resulting sensitivity and specificity of ipsilateral increased vascularity were 79% and 84% respectively. The adjacent vessel sign (AVS) was present in 46 of the 52 patients with breast cancer and 18 of the 56 patients with benign lesions. The resulting sensitivity and specificity of the adjacent vessel sign were 89% and 68% respectively. The accuracy of ipsilateral increased vascularity and the AVS were 84% and 76%. The positive predictive value (PPV) and negative predictive value (NPV) for ipsilateral increased vascularity were 82% and 81% and for AVS were 71% and 86% respectively. Overall accuracies were 82% and 79%. Conclusion: It can be concluded that MR angiograms generated from dynamic contrast enhanced 3D MR images can be used successfully in evaluation of breast vascularity. Ipsilateral increased vascularity and the AVS were strongly associated with breast cancer.

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