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磁共振扩散加权成像对乳腺炎性病变的诊断价值探讨
作者:李逢芳 刘万花 潘淑淑 
单位:东南大学附属中大医院
关键词:乳腺 炎性病变 磁共振成像 扩散加权成像 
分类号:
出版年·卷·期(页码):2012·40·第一期(14-19)
摘要:

目的:探讨磁共振扩散加权成像(diffusion weighted imaging,DWI)对乳腺炎性病变的诊断价值。方法:收集经活检或手术病理证实的乳腺炎性病变33例(其中12例炎症伴脓肿形成)。全部病例行磁共振STIR及DWI检查,DWI采用三组b值扫描(b=400s/mm2,800s/mm2,1000s/mm2)。分析炎性病变的STIR及DWI表现,测量其ADC值并进行统计学分析。结果:(1)81.82%(27/33)炎性渗出在STIR上表现为散在的斑片状及点条状高信号影,18.18%(6/33)表现为等-略低信号;75.75%(25/33)炎性渗出在DWI上也表现为散在点片状或条状高信号,但信号强度低于STIR, 且显示的炎性渗出范围均较STIR要小,24.24%(8/33)呈等信号;脓肿在DWI及STIR上均表现为境界较清晰的结节状均匀高信号影,随b值的增大由于炎性渗出的信号强度衰减明显,而脓肿衰减不明显呈明显高信号;(2)随b值的增大,100%(25/25)炎性渗出DWI信号强度呈现逐渐减低,84%(21/25)呈现面积逐渐减小;而83.33%(10/12)脓肿的信号强度表现为无明显变化,66.67%(8/12)呈面积无明显变化;(3)同一b值下,脓肿与邻近炎性渗出,炎性渗出与正常腺体及脓肿与正常腺体之间ADC差异均有统计学意义(p<0.05);(4)炎性渗出及脓肿在3个b值下的ADC值差异均具有统计学意义,且b值越小,ADC值越大。结论: STIR及DWI相结合是乳腺炎性病变重要的补充检查手段,DWI对脓肿的显示具有重要价值。

Objective:To investigate the diagnostic value of diffusion-weighted magnetic resonance imaging(DW-MRI)in patients with inflammatory lesions of breast.Methods:Thirty-three female patients(including twelve inflammatory lesions wtih abscess formation) pathologically proven mastitis were all examined with MR diffusion-weighted imaging(MR - DWI ) and Short T1 Inversion Recovery (STIR). All patients were scanned with diffenrent b values(b=400-0 s/mm2,800-0 s/mm2,1000-0 s/mm2 respectively) in DWI. Then the ADC value were calculated and the findings of lesions in DWI and STIR were analyzed. Results: 1. 81.82% Inflammatory exudation mostly manifested patchy or dot-linear high signal intensity and 18.18% manifested equal-low signal in STIR, 75.75% manifested scatter dot-linear high intensity in DWI and the signal intensity is lower than in STIR and the scape of the exudation is all smaller than in STIR, 24.24% manifested equal signal. All abscess manifested homegenious high signal intensity with well-defined margin in STIR and DWI. All abscess were well shown with b value increasing due to the exudation sharply lower.2. 100% inflammatory exudation were lower in signal intensity and the 84% decreased in area of exudation with the b value increasing, but most the signal intensity and area of abscess had no change,they were respectively 83.33% and 66.67% .3. Under the same b value, All the ADC values have significant differences between the abscess and the inflammatory exudation, the inflammatory exudation and the normal breast tissue , the abscess and the normal breast tissue(p<0.05).4. There were significant differences among the ADC value of different values of the inflammatory exudation and the abscess. The lower the b value, the higher the ADC value. Conclusion: The combination of STIR and DWI is an important supplemental method for diagnosing inflammatory lesions, DWI can play important role in demonstrating the abscess.

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