磁共振成像在乳腺癌保乳手术中的应用价值

Value of magnetic resonance imaging for breast - conserving surgery

目的探讨磁共振成像在乳腺癌保乳手术中的应用价值。方法对2004年5月至2007年12月通过常规影像学检查符合保乳手术指征的52例乳腺癌患者术前进行乳腺磁共振检查，以检出多中心性乳腺癌病例，同时在增强扫描联合脂肪抑制成像中对肿瘤大小以及周围浸润范围进行准确测定，以确定手术切除的最小范围。结果根据52例乳腺癌患者的磁共振诊断，多中心性乳腺癌3例，单发乳腺癌49例，并且发现单发乳腺癌中有3例存在较广泛的乳管内浸润。本组行保乳手术47例，首次切缘阴性率为93.6％（44／47）。结论磁共振成像对多中心性乳腺癌的检出及乳腺癌乳管内浸润的判断具有明显优势，对于明确乳腺癌保乳适应证以及准确把握保乳手术的切除范围具有较高的临床应用价值。

Objective To evaluate magnetic resonance imaging （MRI） for breast-conserving surgery. Methods In this study, 52 cases of breast cancer eligible for breast-conserving surgery judged by traditional screening methods from May 2004 to December 2007 were inspected preoperatively with MRI in order to detect the cases of muhicentric breast cancer. At the same time, tumor size and invasive extent was measured accurately with enhanced magnetic resonance sequence combined with fat-suppression to determine the minimally extent of the surgical excision required. Results In the 52 cases of breast cancer patients, 3 cases of muhicentric breast cancer and 49 cases of single breast cancer were diagnosed by MRI, there were 3 cases with extensive intraductal carcinoma in the cases of single breast cancer. The primary negative margin rate was 93.6%（44/47） in the 47 cases with breast-conserving surgery. Conclusions MRI has the superiority to detect the muhicentric disease and the extensive intraductal carcinoma of breast cancer. Therefore MRI is useful in determining the indication and the extent of surgical excision of breast-conserving surgery.