乳腺髓样癌与纤维腺瘤MRI影像特征及病理对比研究

Comparison of MR Imaging Characteristics and Pathological Findings in Medullary Carcinoma and Fibroadenoma of the Breast

目的研究乳腺髓样癌的磁共振表现和临床病理特征,并与纤维腺瘤进行比较。资料与方法以行乳腺MRI检查并经病理证实的24例女性乳腺髓样癌患者为研究组,32例女性乳腺纤维腺瘤患者为对照组,术前15d内行MRI检查,分析两组患者的MRI表现及病理特征。结果研究组有10例发生淋巴结转移,而对照组无淋巴结转移。实验组在所有序列上均清晰可见,直径一般为1.0～4.3cm;T1WI均呈低信号,T2WI4例呈低信号,20例呈明显高信号,时间-信号强度曲线(TIC)为Ⅲ型和Ⅱ型;对照组形态多呈类圆形或分叶状,边界光整;T1WI18例呈低信号,14例呈等信号,T2WI2例呈低信号,TIC为Ⅰ型;两组形态、内部强化及病理分级、TIC方面比较,差异有统计学意义(P<0.05),而患者年龄、病灶大小比较,差异无统计学意义(P>0.05)。结论 MRI影像表现及病理特征有助于诊断乳腺髓样癌。

Purpose To evaluate the MR imaging and clinical-pathological findings of medullary carcinoma of the breast,and to compare with those of fibroadenoma.Materials and Methods 24 cases of breast medullary carcinoma （EG,study group） and 32 cases of breast fibroadenoma （CG,control group） confirmed by pathology were studied.All patients underwent MRI within 15 days before surgery,the MR features and clinical-pathological findings of breast cancer were reviewed.Results 10 cases of medullary carcinoma had lymph node metastases,and no lymph node metastases of fibroadenoma was observed.Tumor diameters were 1.0-4.3 cm.Tumors showed low signal on T1WI;on T2WI,4 cases were low signal,20 cases were high signal.TIC were type Ⅲ in 13 cases （54.2%） and type Ⅱ in 7 cases （29.2%）;CGs were spherical or speculated with smooth borders.18 cases were low signal and 14 cases were isointense on T1WI,when 2 cases were low signal on T2WI.TICs were type Ⅰ.There were statistical differences in the shape,internal enhancement,histologic tumor grade and TIC （P 〈 0.05）.No statistical difference in age and mass margin was showed （P 〉 0.05） between medullary carcinoma and fibroadenoma.Conclusion MR imaging findings and pathological feature may be used for diagnosing medullary carcinoma of the breast