术前磁共振成像对乳腺癌保乳手术的临床意义

Clinical Significance of Preoperative Magnetic Resonance Imaging on Breast Conserving Surgery of Patients with Breast Cancer

目的探讨磁共振成像(magnetic resonance imaging,MRI)对评估保乳手术可行性的价值。方法87例经临床体检和超声检查后计划进行保乳术的乳腺癌患者,均行术前乳房MRI、其中65例行钼钯X线检查,手术标本均行组织病理学检查。将MRI和钼靶X线检查结果与组织病理学结果进行对照,分析是否适宜行保乳术(breast-conserving sur-gery,BCS)。结果MRI检查能够准确检测出乳腺癌灶的数目、大小和淋巴结状况,测量切除肿块/乳房体积比。通过MRI检查结果综合判断71例可行BCS、16例不可行BCS,与病理检查结果的符合率达91.6%,高于钼钯X线检查。结论术前MRI检查能为乳腺癌BCS患者的筛选提供较全面而准确的信息,是传统的影像学方法的有益补充。

Objective To investigate the value of magnetic resonance imaging （MRI） for assessing feasibility of breast conserving surgery （BCS） of breast cancer. Methods Eighty seven breast cancer patients who were planed BCS after clinical breast examination and ultrasonography underwent preoperative breast MRI, and 65 of the patients underwent also preoperative mammography. Macroscopic and microscopic features of pathomorphology of resected specimens were observed. The results of MRI, mammography and histopathology were comparatively analyzed. Results MRI could accurately assess the number, size of breast cancer, axillary nodes status, as well as volume ratio of tumor and breast. Seventy one patients were considered eligible for BCS and 16 patients were not considered eligible by MRI and the coincidence rate between MRI and pathology was 91.6% and higher that between mammography MRI and pathology. Conclusion Preoperative breast MRI can provide complete and accurate information for BCS of breast cancer and be a powerful supplement to the conventional imaging methods.