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find Author "蒲杨梅" 2 results
  • Differential diagnosis significance of 3.0T MRI united-sequence examination forbenign and malignant breast lesions

    Objective To explore the differential diagnosis significance of 3.0T MRI united-sequences examination in the diagnosis of benign and malignant breast lesions. Methods A total of 67 breast lesions of 59 patients were collected prospectively, which be treated at the Sichuan Provincial People’s Hospital during July 2015 to January 2017. All patients were underwent bilateral breast 3.0T magnetic resonance plain scan, diffusion weighted imaging, and dynamic enhanced scan successively before surgical operation. Analysis of morphological features of the benign and malignant breast lesions, the time-signal intensity curve (TIC), the apparent diffusion coefficient (ADC), and the combination diagnosis of them were performed. Results Of all 59 patients, 67 lesions were confirmed by histopathology, including 18 benign lesions and 49 malignant lesions. The morphological features (including margin, shape, border, and evenness), the types of TIC of dynamic enhancement, and ADC value between the benign lesions and malignant lesions were statistically significant (P<0.05). The sensitivity and specificity of Fischer scoring system was 89.8% (44/49) and 61.1% (11/18) respectively. The sensitivity and specificity of TIC types was 83.7% (41/49) and 77.8% (14/18) respectively. The diagnostic threshold of ADC value was 1.012×10–3 mm2/s, with the sensitivity and specificity for the diagnosis was 91.8% (45/49) and 83.3% (15/18) respectively. The sensitivity and specificity of the combination of Fischer scoring system and TIC type for diagnosis between benign and malignant breast lesions was 95.9% (47/49) and 72.2% (13/18) respectively. The sensitivity and specificity of the combination of Fischer scoring system, TIC type, and ADC value for benign and malignant breast lesions was 98.0% (48/49) and 83.3% (15/18) respectively. Conclusion The combination of Fischer scoring system, TIC type, and diffusion-weighted imaging for the differential diagnosis between benign lesions and malignant lesions was more effective than single imaging method.

    Release date:2018-07-18 01:46 Export PDF Favorites Scan
  • 结节肿块型乳腺导管内乳头状瘤的MRI表现及与乳腺小浸润性导管癌的鉴别诊断

    目的 分析结节肿块型乳腺导管内乳头状瘤(intraductal papilloma,IDP)磁共振成像(magnetic resonance imaging,MRI)的影像学表现,加深对IDP的MRI特征的认识,并探讨其与直径小于2 cm的乳腺浸润性导管癌(invasive ductal carcinoma,IDC)的鉴别诊断特征。方法 回顾性分析2018年1月至2021年6月期间在四川省妇幼保健院经手术后病理学检查证实的28例乳腺结节肿块型IDP和34例直径小于2 cm的IDC的MRI表现,包括病灶大小、形态、边缘、是否有毛刺征、病灶周围有无扩张导管、病灶的最大径是否沿乳腺导管方向走行、病灶是否距乳头4 cm以内、平扫T2WI信号、表观扩散系数(apparent diffusion coefficient,ADC)值、动态增强时间-信号强度曲线(time-signal intensity curve,TIC)类型、早期强化率以及增强扫描病灶内部强化方式演变特征。 结果 2组比较,肿瘤直径(P<0.001)、形态(P<0.001)、边缘(P<0.001)、病灶周围有无扩张导管(P<0.001)、病灶最大径是否沿乳腺导管方向走行(P<0.001)、病灶是否距乳头4 cm以内(P=0.009)、ADC值(P=0.001)、TIC曲线类型(P<0.001)、早期强化率(P<0.001)以及增强扫描病灶内部强化方式演变特征(P=0.010)的差异均具有统计学意义。12 例(35.3%)IDC 边缘出现毛刺征,而IDP无上述表现。8 例(23.5%)IDC 在早期及延迟期强化中均表现为边缘强化,而IDP组仅1 例在早期及延迟期表现为小环状强化,且病灶前方可见扩张导管影。9例(32.1%)IDP病灶周围有导管扩张,而IDC无此征象。 结论 结节肿块型IDP与小IDC的MRI影像表现具有一定相似性,但两者病灶边缘、与导管的关系(有无相关导管扩张、是否位于乳头附近、病灶最大径是否沿导管方向走行)、早期强化率以及增强扫描病灶强化方式演变特征存在差异,对两者的鉴别诊断具有重要意义。TIC曲线以及ADC值不能单独作为IDP与IDC的鉴别征象。

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