Department of Radiology, The University of Chicago, Chicago, Illinois 60637, USA.
J Magn Reson Imaging. 2011 Jun;33(6):1382-9. doi: 10.1002/jmri.22567.
To compare the pathology and kinetic characteristics of breast lesions with focus-, mass-, and nonmass-like enhancement.
A total of 852 MRI detected breast lesions in 697 patients were selected for an IRB approved review. Patients underwent dynamic contrast enhanced MRI using one pre- and three to six postcontrast T(1)-weighted images. The "type" of enhancement was classified as mass, nonmass, or focus, and kinetic curves quantified by the initial enhancement percentage (E(1)), time to peak enhancement (T(peak)), and signal enhancement ratio (SER). These kinetic parameters were compared between malignant and benign lesions within each morphologic type.
A total of 552 lesions were classified as mass (396 malignant, 156 benign), 261 as nonmass (212 malignant, 49 benign), and 39 as focus (9 malignant, 30 benign). The most common pathology of malignant/benign lesions by morphology: for mass, invasive ductal carcinoma/fibroadenoma; for nonmass, ductal carcinoma in situ (DCIS)/fibrocystic change(FCC); for focus, DCIS/FCC. Benign mass lesions exhibited significantly lower E(1), longer T(peak), and lower SER compared with malignant mass lesions (P < 0.0001). Benign nonmass lesions exhibited only a lower SER compared with malignant nonmass lesions (P < 0.01).
By considering the diverse pathology and kinetic characteristics of different lesion morphologies, diagnostic accuracy may be improved.
比较具有局灶性、团块性及非团块性强化特征的乳腺病变的病理学和动力学特征。
共选取 697 例患者的 852 个 MRI 检出的乳腺病变进行了经 IRB 批准的回顾性分析。所有患者均接受了动态对比增强 MRI 检查，包括 1 次平扫及 3 到 6 次增强 T1WI。增强类型分为团块、非团块及局灶性，并通过初始强化百分比（E1）、达峰时间（Tpeak）和信号强化比（SER）来量化动力学曲线。在每种形态类型中，比较了恶性与良性病变之间的这些动力学参数。
共 552 个病变被分为团块（396 个恶性，156 个良性）、261 个非团块（212 个恶性，49 个良性）和 39 个局灶性病变（9 个恶性，30 个良性）。按形态学分类，恶性/良性病变最常见的病理学类型为：团块，浸润性导管癌/纤维腺瘤；非团块，导管原位癌（DCIS）/纤维囊性变（FCC）；局灶性，DCIS/FCC。良性团块病变的 E1、Tpeak 均显著低于恶性团块病变，SER 也显著低于恶性团块病变（P<0.0001）。良性非团块病变的 SER 仅显著低于恶性非团块病变（P<0.01）。
考虑到不同病变形态的不同病理学和动力学特征，诊断准确性可能会提高。
