乳腺导管内癌的MRI表现

Features of Magnetic Resonance Imaging in Breast Ductal Carcinoma in Situ

目的分析乳腺导管内癌在MRI上的特征表现。资料与方法经术后病理证实的38例乳腺导管内癌患者,术前行常规MRI、增强MRI及扩散加权成像检查,分析MRI特征表现及对诊断的价值。结果 MRI显示38例患者中非肿块型26例,平均表观扩散系数(ADC)为1.34×10-3mm2/s;肿块型12例,平均ADC值为1.27×10-3mm2/s。增强MRI显示病灶局限在一个象限内、呈节段性分布29例,区域性分布9例。非肿块型的26例患者中,节段性强化12例,导管样强化8例,网状强化4例,斑点样2例。12例肿块型,边缘不规则、分叶状8例,边缘光滑4例;均匀强化10例,环形强化2例。增强曲线中流入型6例,均为非肿块型;平台型17例,非肿块型12例,肿块型5例;廓清型15例,非肿块型8例,肿块型7例。MRI诊断BI-RADS分级:3级5例,4、5级33例。结论非肿块型、节段性分布,不均匀强化、导管样或线样强化高度提示乳腺导管内癌。

Purpose To analyze MRI features of the breast ductal carcinoma in situ （DCIS）. Materials and Methods 38 cases of DCIS were enrolled and received conventional MRI examination. The imaging findings were analyzed and the diagnostic value was evaluated. Results The lesion was divided into nonmass lesions （26 cases） with a mean apparent diffusion coefficient （ADC） of 1.34 × 10^-3mm2/s, and mass lesions （12 cases） with a mean ADC of 1.27× 10^-3mm2/s. The lesions were limited in one quadrant with a segment distribution in 29 cases, diffusion and regional distribution in 9 cases. The enhancement pattern included heterogeneous patchy enhancement in 12, duct-like enhancement in 8, latticed enhancement in 4, flocculent enhancement and multiple dotted enhancement in 2, homogeneous nodular enhancement in 10, ring-like enhancement in 2, irregular lobular enhancement in 8, and smooth margin enhancement in 4. The enhancement curve included continuous ascending type in 6 mass lesions, fiat type in 17, and clearance type in 15. For MR1 BI-RADS category, 5 cases were category 3, 33 cases were category 4 and 5. Conclusion The DICS should be considered when the lesions have MRI features of nonmass type, segment distribution, and with heterogeneous patchy, duct-like or latticed enhancement.