磁共振邻近血管征对乳腺良恶性肿瘤的鉴别诊断价值

目的：分析63个乳腺肿瘤的磁共振表现，探讨病灶邻近血管征（AVS）在乳腺良恶性肿瘤鉴别诊断中的价值。材料与方法：回顾性分析经病理证实的60例63个乳腺肿瘤的MR动态增强图像，在工作站获得剪影图像及3DMIP图像，分析病灶邻近血管征与病灶良恶性、病灶大小的关系。结果：血管征在恶性肿瘤出现率（55％）明显高于良性肿瘤出现率（26．09％），差异有统计学意义（χ2=4．944，P〈0．05）。病灶平均直径与血管征有关，病灶直径〉2cm的出现率（65．52％）明显高于直径≤2cm的出现率（26．47％），差异具有统计学意义（χ2=9．664，P〈0．05）。血管征分3型，单支血管型17例，其中恶性12例，良性5例；多支血管型7例，其中恶性6例，良性1例；血管扩张型4例，均为恶性。血管征诊断乳腺癌的敏感性为55．0％，特异性73．91％，阳性预测值78．57％，准确度61．90％。结论：血管征在鉴别诊断中有较高价值，表现为多支血管及扩张血管征时高度提示恶性；血管征可以作为乳腺癌多因子评估的有力补充。

Value of the Adjacent Vessel Sign on Breast MRI for the Differentiation Between Benign and Malignant Breast Lesions

Purpose： To investigate the MR imaging of 63 lesions and to evaluate the role of Adjacent Vessel Sign （AVS） for differentiating benign from malignant breast lesions. Materials and Methods： Dynamic contrast-enhanced MR breast scan of 60 patients （63 lesions） with histopathologically confirmed were evaluated retrospectively. The subtraction and 3D -MIP images were analyzed in MR work station. To verify the values of AVS and assess correlation between AVS and lesions sort, lesion size. Results ： The AVS was significantly associated with malignancy than benign lesions （ P 〈 0. 05 ） , lesions 〉 2 cm more often presented with an AVS than did those lesions 〈 2cm （ P 〈 0. 05 ） ; The AVS included 3 types, type I was one vessel included 17 lesions of 12 malignant and 5 benign lesions; type II was multi-vessels , with 6 malignant and 1 benign lesions; type III was dilated- vessel, all 4 lesions were malignant. The sensitivity and specificity of AVS were 55. 0% and 73.91%, the positive predictive value was 78.57%, accuracy was 61.90%. Conclusion： the AVS has high accuracy in differentiating benign from malignant breast lesions, especially multi-vessels or dilated-vessels were seen. AVS can be used to additional common practice of breast MR.