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1、探討MRI動(dòng)態(tài)增強(qiáng)血管成像對(duì)乳腺癌的診斷價(jià)值董棟1，2,3王新怡3（通訊作者）（1山東省醫(yī)學(xué)科學(xué)院山東濟(jì)南250062）（2濟(jì)南大學(xué)，山東省醫(yī)學(xué)科學(xué)院醫(yī)學(xué)與生命科學(xué)學(xué)院山東濟(jì)南250001）（3山東大學(xué)附屬千佛山醫(yī)院山東濟(jì)南250041）【摘要】目的探討MRI動(dòng)態(tài)增強(qiáng)血管成像中單側(cè)乳腺血供增加對(duì)同側(cè)乳腺癌的診斷價(jià)值。資料與方法對(duì)169例乳腺疾病患者行乳腺動(dòng)態(tài)增強(qiáng)磁共振檢查，在最大密度投影圖像上進(jìn)行血管計(jì)數(shù)，當(dāng)血管長(zhǎng)度≥3cm且最大直徑≥2mm時(shí)，列入篩選合格范圍，得到兩側(cè)的差異血管數(shù)目，即血管得分
2、。兩側(cè)乳腺合格血管差值≥2個(gè)時(shí)認(rèn)為單側(cè)乳腺血供增加。分析乳腺單側(cè)血供增加診斷同側(cè)乳腺癌的靈敏度、特異度，以及與病灶大小的關(guān)聯(lián)。結(jié)果以乳腺單側(cè)血供增加作為同側(cè)乳腺癌的診斷標(biāo)準(zhǔn)的靈敏度為65%,特異度為84%,陽(yáng)性似然比（+LR）為4.06,陰性似然比（-LR）為0.42。T3腫瘤的平均血管評(píng)分顯著高于T1和T2腫瘤。結(jié)論MRI動(dòng)態(tài)增強(qiáng)血管成像可以很好的顯示雙側(cè)乳腺整體血供，單側(cè)乳腺血供增加與同側(cè)乳腺癌相關(guān)?！娟P(guān)鍵詞】乳腺癌磁共振成像最大密度投影【中圖分類號(hào)】R737.9【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】1672
3、-5085（2013）45-0036-02Diagnosticvalueofdynamiccontrast-enhancedMRIvesselimaginginbreastcancerDONGDongl.2.3,WANGXin-yi2（1.ShandongAcademyofMedicalSciences,Jinan250062,China2.SchoolofMedcineandLifeSciences,UniversityofJinan-ShandongAcademyofMedicalSciences,Jin
4、an250001,China3.DepartmentofImaging,QianfoshanHospitalaffiliatedtoShandongUniversity,Jinan250014,China)[Abstract]ObjectiveThisstudywasdonetoestimatethediagnosticperformanceofone-sidedvascularprominenceforipsilateralbreastcancer.MaterialsandMethodsAtotalof16
5、9patientsunderwentbilateralcontrastenhancedmagneticresonanceimaging.Vessels≥2mmindiameterand≥3cminlengthwerecountedonmaximumintensityprojections,adifference≥2innumberbetweenthetwobreastswasconsideredone-sidedvascularprominence,theassociationofone-s
6、idedvascularprominencewithipsilateralbreastcancerandthediameterofinvasivelesionswereanalysedusingMaximumintensityprojections.ResultsWhenadifferenceofatleasttwovesselswasscoredasvascularasymmetry,thesensitivity,specificity,positivelikelihoodratio,andnegative
7、ofunilaterallyincreasedvascularityassociatedwithipsilateralmalignancywere69%,92%,8.72,and0.34,respectively.ConclusionMRIvascularmappingisaneffectivemethodfordeterminingbreasttissuevascularization.Ipsilateralincreasedvascularitywascommonlyassociatedwithmalig
8、nantbreastlesions.【Keywords]BreastcancerMagneticresonanceimagingMaximumintensityprojections磁共振成像正逐步應(yīng)用于乳腺癌的診斷，臨床適應(yīng)癥包括：乳腺腫瘤的分期、乳腺癌高危人群的篩查、新輔助化療療效的評(píng)估等。0前，乳腺磁共振檢查被公認(rèn)為檢測(cè)乳腺癌有較高的靈敏度，但特異度不高[1】。在這項(xiàng)研究中，我們運(yùn)用磁共振乳腺
