乳腺恶性病变的钼靶X线及磁共振表现对照研究

Correlative Analysis of Mammographic and MRI Findings of Breast Malignant Lesions

目的:探讨乳腺恶性病变的钼靶X线和MRI表现及与病理结果的关系。方法:回顾性分析38例经穿刺或手术病理证实的乳腺恶性病变的钼靶X线、MRI表现,并与病理结果对比分析。38例中乳腺浸润性导管癌21例,导管原位癌11例,黏液癌3例,腺样囊性癌2例,髓样癌1例。结果:乳腺恶性病变主要表现为乳腺结构及局部血管异常,肿瘤多呈星芒状、蟹足样,边缘多毛刺状、不光滑。钼靶X线示病灶内部密度不均匀,钙化点数量较多,多呈沙粒样,可成簇生长,也可弥散在腺体的一个区内。主要MRI表现为病灶T1WI多呈低、等信号,T2WI多为混杂信号,增强扫描呈明显不均匀强化。结论:钼靶乳腺摄影操作简单,准确性较高,是乳腺恶性病变的首选检查方法。MRI能清楚的显示乳腺内病变的细微结构,提高诊断准确性。

Objective：To study the correlation of X-ray and MRI features of breast malignant lesions with histopathology. Methods：The X-ray and MRI features of breast malignant lesions in 38 cases were studied retrospectively and correlatively compared to the corresponding findings of histopathological results. Results： There were 21 cases with infiltrating ductal carcinoma, 11 cases with ductal carcinoma in sit u,3 cases with breast alveolar cancer, 2 cases with adenoid cystic carcinoma and 1 case with medullary carcinoma in our collection. The major features of malignant breast lesions revealed abnormal vessels and structural abnormalities. The margins of the lesions were blurred and unclear. On X-ray mammographic images, the lesions showed heterogeneous in density with a considerable quantity of sand-like calcified granules,diffusely distributed or gathered in clusters. The MR signs of breast malignant lesions demonstrated hypo or isointense signal intensity on T1 WI images and in most of the cases,mixed signal intensity on T2WI images. On postcontrast scans, the tumors showed remarkably heterogeneous enhancement. Conclusion：X-ray mammography was the first choice of imaging examination modalities for breast malignant lesions because of its simple procedures and rather high diagnostic accuracy rate; since intricate structural changes of malignant breast lesions could be clearly shown by MRI,the diagnostic accuracy rate was improved.