中文摘要：

目的探讨MRI氢质子波谱成像（^1H-MRS）在常规动态增强MRI检查诊断的乳腺BI-RADS 3病变中的应用价值。方法应用1.5T MRI对常规动态增强MRI检查诊断为BI-RADS 3乳腺病变的34例患者、39处病灶再次行（^1H-MRS）检查。以Cho峰信噪比（SNR）≥2作为阳性的诊断标准,Cho峰阳性病灶重新评级为BI-RADS 4,阴性患者维持BI-RADS 3不变。以穿刺活检或手术病理为金标准,分析^1H-MRS胆碱峰对乳腺癌与乳腺良性病变的诊断价值。结果6处病灶（累及5例患者）^1H-MRS检查Cho峰阳性从而被重新评估为BI-RADS 4,病理证实均为乳腺癌。另外33处病灶Cho峰阴性维持BI-RADS 3分级不变,病理证实均为良性病变。^1H-MRS检查胆碱峰在乳腺良、恶性病变中有显著统计学差异（P〈0.001）。结论 ^1H-MRS对鉴别常规动态增强乳腺MRI诊断的BI-RADS 3病变中可能存在的恶性病变具有重要作用,可进一步提高BI-RADS分级的准确性。

英文摘要：

Objective To explore the diagnostic value of Proton MR Spectroscopy（^1H-MRS）in breast BI-RADS 3leisions diagnosed with conventional magnetic resonance imaging（MRI）.Methods Thirty-four patients with 39BI-RADS 3leisions underwent ^1H-MRS using 1.5T MR scanner.Leisions with a signal to noise Ratio of the choline peak ≥ 2（defined as positive choline peak）were re-classified as BI-RADS 4,otherwise BI-RADS 3was maintained.Diagnostic value of ^1H-MRS for identifying breast cancers from benign leisions was analyzed by using biopsy or surgical pathology as the reference standard.Results Six leisions（5patients）with positive choline peaks were re-classified as BI-RADS 4and pathologically confirmed breast cancers,the others with negative choline peaks were pathologically confirmed benign breast leisions.There was significantly difference for choline peak of ^1H-MRS in the benign and malignant breast lesions（P〈0.001）.Conclusion ^1H-MRS can reveal breast cancers from BI-RADS 3leisions diagnosed with conventional MRI,there by improving accuracy of BI-RADS classification.