多层螺旋ct对乳腺癌诊断的意义

Vol.26No.4Apr.2006JournalofShanghaiJiaotongUniversityMedicalScience19’1(E-maildbwang)sh16*.net+02,-(,-9-200604(0419(04CT112112004382CTMSCT120MSCT35s60s150sCTCT120891006112862CT78%82%84%92%MSCTCT.737/9.814/420DiagnosisofBreastCarcinomabyMultisliceSpiralCTZHAOYa-e1HANBen-yi1WANGDeng-bin2LUYang11DepartmentofMedicalImagingShanghaiShidongHospitalShanghai200433China2DepartmentofRadiologyRuijinHospitalSchoolofMedicineShanghaiJiaotongUniversityAbstract+Objective+ToexplorethediagnosticvalueofmultislicespiralCTMSCTforbreastcarcinoma.Methods+Onehundredandtwentyconsecutivesuspiciouscasesofbreastcarcinomadiagnosedclinicallyand/orbyimagingmodalitieswerestudiedwithMSCTprospectively.Thedynamiccontrast-enhancedserialscanningwasdoneasfollowsScanningwastriggered*,searlyarterialphaseafterbeginningofcontrastagentinfusionataspeedof*mL/sbyhighpressureautomaticinjectorandwouldberepeatedatthetimepointof60sand1,0s.EventuallytheCTdiagnosticresultswerecomparedwiththepathologicalconsequencestocalculatethediagnosticaccuracyofMSCTforbreastcarcinoma.+Results+Eighty-ninepatientswith100fociofbreastcancerfrom120suspiciouscaseswereconfirmedpathologicallyandtheirimagingdatawereanalyzed.Amongthe-9cases61caseswereinvasiveductalcarcinomas12ductalcarcinomasinsitu-invasivelobularcarcinomas6medullarycarcinomasand2inflam-matorycarcinomas.Accordingtolesionmorphologicappearancelesionenhancementmodetime-densitycurveofle-sionandcombinationofalltheabovethreeparametersthediagnosticaccuracieswere’-%-2%-4%and92%respectively.+Conclusion+MSCThasagreatclinicalvalueindiagnosingbreastcarcinoma.Keywords+breastcarcinoma+multislicespiralCT+diagnosis++XMRICTCTCTMRICTXMRICTCTmultislicespiral914Vol.26CTMSCTCT200110&200’’120MSCT26&(2)2.6MSCTGElightspeedQX/I)CTSiemensSomatomEmotion6CT’mm1.0(0&100mL2&*mL/s*’s60s1’0s’&(sCTCT①②③④⑤⑥⑦regionofinterestROICT+CTCTCT120(,(,(,61*(12(’622CT1.(1(62**’210061’’1*1’26(21’≤2cm-6.2cm/’cm’cm,2.6(’6’62*12)(11,12()(66262*10)cm1cm*.-666)’’(%1012102).+’)2-0%1216%101)%10(210’*2’.)*CT*(((%)&2(mm12mm1’mmCT024No.4CTCT-CTCT92%1Fig1MultiplecarcinomafociintherightbreastAbothlesionsarrowssized2cm&’cmintheouterquadrantandsized(cm&(cminthemiddlepartoftherightbreastweregreatlyenhancedintheearlyarterialphaseafteradministrationofcontrastmediaBbothlesionsarrowsreachedtheirenhancementpeaksinthelatearterialphasewithmuchmoreconspicuityConemoretinylesionsized)mm&)mmarrowwithgreatenhancementwasdetectedinthebreastparenchymajustbeneaththesub-cutaneousfatlayer2-Fig2Time-densitycurveofwashouttypeThebreastcarcinomawasgreatlyenhancedanditshowedclearlyarapidwash-inmodeearlyafteradministrationofcontrastmediaandarapidwash-outmodeinthedelayedphase(-)CT*-+’-4XCTMSCTMSCTMSCTMSCTCTCT*-9MSCTCT-(,-(’MSCTMSCT+-%MSCT2)-9vascularendothelialgrowthfactorVEGFintrotumoralmicrovessel124Vol.2682%MSCT-CTMRICT-1360s-84%MSCT92%1012-13MRI3-*MSCT+MSCT-MPVRMSCTCTMSCTCT,CTXCTMRIXCTCTMRI1.M.1996**-108.2.M.1999128-1*3.3+.J.2001201*-6.4.J.2002361196*-966.*.M.200*92-121.6.CTJ.19983212,-31.,.CTJ.200*392169-1,2.8GoldbergPAWhiteCSMcAvoyMAetal.CTappearanceofthenormalandabnormalbreastwithmammographycorrelationJ.ClinImage1994184262-2,2.9BassettLW.ImagingofbreastmassesJ.RadiolClinNorthAm2000384669-691.10TozakiMKobayashiTUnoSetal.Breast-conservingsurgeryaf-terchemotherapyvalueofMDCTfordeterminingtumordistributionandshrinkagepatternJ.AJR20061862431-439.11HikinoHOkadaNKodamaKetal.Computed-tomographicfea-turesofinvasivelobularcarcinomaJ.ClinImaging200*296383-388.12MiyakeKHayakawaKNishinoMetal.BenignormalignantdifferentiatingbreastlesionswithcomputedtomographyattenuationvaluesondynamiccomputedtomographymammographyJ.JCom-putAssistTomogr200*296,,2-,,9.13IzzoLStasollaABassoLetal.Characterizationoftumoralle-sionsofthebreastpreliminaryexperiencewithmultislicespiralCTJ.JExpClinCancerRes200*242209-21*.200*-08-10224