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目的:研究乳腺良、恶性疾病的形态学表现、早期增强率和时间—密度曲线的特点,探讨应用螺旋CT鉴别乳腺良、恶性病变的价值。方法:采用双排探测器螺旋CT平扫和增强扫描,分析病变形态学特点、增强率和时间—密度曲线,与病理学结果对照,探讨各种方法鉴别乳腺良、恶性疾病的价值。结果:患者38例,共43个病灶,乳腺癌28个,良性病变15个。11个病灶表现为片状影,32个表现为肿块影,21个恶性肿块中有毛刺和分叶征象的各12个,11 个良性肿块中有毛刺和分叶征象的分别为 1 个和 2个。20个乳腺癌的时间—密度曲线类型为Ⅲ型,11个良性病变为Ⅰ型曲线,Ⅱ型曲线中良、恶性病变有较多重叠。增强率反映了病变区的血供情况,以 E1min、E3min作为鉴别良、恶性的标准较 E5min为佳。结论:乳腺恶性肿瘤毛刺、分叶征象比良性病变多见;早期增强率和时间—密度曲线类型对鉴别诊断有重要参考价值,三者综合分析能有效提高诊断的准确率。螺旋CT从多个角度对乳腺病变进行分析,提供了更多的鉴别诊断信息,有重要的临床应用价值。
Objective: To study the morphological features, early enhancement rate and time-density curve of benign and malignant breast diseases, and to explore the value of using spiral CT in differential diagnosis of benign and malignant breast lesions. Methods: The double-detector helical CT scan and enhanced scan were used to analyze the morphological features, enhancement rate and time-density curve, and compared with pathological results to explore the value of various methods to identify benign and malignant breast diseases. Results: There were 38 patients with 43 lesions, 28 breast cancer and 15 benign lesions. Eleven lesions showed flaky shadow, 32 showed mass shadow, 21 malignant tumors had burr and leaflet signs of each 12, 11 benign masses have burr and leaflet signs were 1 and 2 A Twenty breast cancer time-density curve type Ⅲ, 11 benign lesions for type Ⅰ curve, type Ⅱ curve of benign and malignant lesions have more overlap. The rate of enhancement reflects the blood supply of the lesion area, and E1min and E3min are better than E5min in discriminating between benign and malignant. Conclusion: There are more burr and lobular signs of malignant breast tumors than benign lesions. The types of early enhancement rate and time-density curve have important reference value for differential diagnosis. Comprehensive analysis of the three can effectively improve the diagnostic accuracy. Spiral CT analysis of breast lesions from multiple angles, providing more differential diagnosis, there is an important clinical value.