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目的 评价在同 1次检查中T1W动态增强成像之后进行重T2 W (T 2 W )首次通过灌注成像的可行性 ,以及后者在鉴别乳腺良恶性肿瘤方面的诊断价值。方法 2 9例乳腺病患者在T1W动态增强后进一步行病灶局部的T 2 W首次通过灌注成像 ,分别根据病灶T1W动态增强的早期强化程度和T 2 W首次通过灌注成像的早期信号丢失程度判定病灶的良恶性 ,计算其敏感度、特异度 ,以进行两方法间的比较。结果 应用T1W动态增强成像序列 ,良、恶性病变的信号强度增加率之间差异有显著性意义 (t=2 5 6 3,P =0 0 16 ) ,但两者的早期增强程度范围有很大的重叠 ;早期增强率诊断的敏感度为 94 % ,特异度仅为 2 5 %。应用T 2 W首次通过灌注成像序列 ,良、恶性病变之间的T2 信号强度丢失程度差异有非常显著性意义 (t=4 777,P <0 0 0 1) ,良、恶性病变的早期信号丢失率之间重叠很少 ;早期信号丢失率诊断的敏感度为 88% ,特异度为 75 %。结论 T 2 W首次通过灌注成像在鉴别良恶性乳腺肿瘤方面具有较高特异度 ;在同一患者中 ,T 2 W首次通过灌注成像结合T1W动态增强成像检查是可行的 ,可以提高乳腺MR成像的诊断准确性。
OBJECTIVE: To assess the feasibility of first T2W (T2W) perfusion imaging after dynamic contrast enhanced T1W imaging in the same examination, and to evaluate its diagnostic value in the differential diagnosis of benign and malignant breast tumors. Methods Twenty-nine patients with breast disease underwent T1W dynamic enhancement and then were subjected to local T 2 W perfusion imaging for the first time. The lesions were determined according to the degree of early enhancement of T1W dynamic enhancement and the early signal loss of T 2 W after initial perfusion imaging Of the benign and malignant, calculate the sensitivity, specificity, in order to compare the two methods. Results There was a significant difference in the rate of increase of signal intensity between benign and malignant lesions using T1W dynamic contrast enhancement imaging (t = 2 563, P = 0 0 16), but the range of early enhancement was high Of the overlap; early enhanced rate of diagnosis of 94% sensitivity and specificity of only 25%. There was a significant difference in the loss of T2 signal intensity between benign and malignant lesions using T 2 W first time perfusion imaging (t = 4 777, P 0 01), early loss of signal in benign and malignant lesions There is very little overlap between rates; the sensitivity of early signal loss diagnosis is 88% and the specificity is 75%. Conclusion T 2 W has the highest specificity in the differential diagnosis of benign and malignant breast tumors by the first perfusion imaging. In the same patient, T 2 W is the first time through perfusion imaging combined with T1W dynamic enhanced imaging is feasible and can improve the diagnosis of breast MR imaging accuracy.