不同病理类型的乳腺分叶状肿瘤影像特征分析

Imaging Analysis of Different Pathological Types of Breast Phyllodes Tumor

目的:探讨不同病理类型乳腺分叶状肿瘤的X线、MRI影像学特征。方法:回顾性分析25例26个经手术、病理证实的乳腺分叶状肿瘤患者的临床表现,分析各病理亚型的影像学表现的差异。结果:26个分叶状肿瘤中良性7个,交界性11个,恶性8个。肿瘤形态、大小、位置在各病理亚型间分布无差异。X线检查显示肿块多为密度增高(22/26),良性和交界性多为类圆形,恶性多呈分叶状形态(P=0.033);交界性与恶性分叶状肿瘤边界不清晰,良性边界清晰(P=0.012)。17个肿瘤行MRI检查,T2WI上肿瘤为高信号(12/17),并能见其中更高亮的囊变裂隙区(8/12)。交界性和恶性分叶状肿瘤在T2WI上易出现低信号分隔(P=0.021),增强扫描后也显示低信号分隔(P=0.028)。结论:分叶状肿瘤的X线及MRI表现有一定特征,MR-T2WI及增强扫描对判断分叶状肿瘤的病理亚型有一定的价值。

Purpose： To study the MRI and X-ray mammography features of different pathological types of phyllodes tumors of breast. Methods： The clinical manifestations and imaging findings of 25 patients with 26 different subtype phyllodes tumors confirmed by pathology were analyzed retrospectively. Re- sults： Twenty six phyllodes tumors included 7 benign, 11 borderline and 8 malignant ones. Shape, size and location of the tumors were with no statistical difference between the various histological subtypes. On mammography, most of the tumors were shown as high density lesions （22/26）. The Shape of benign and borderline tumors were round, and malignant tumors were lobular （P=0.033） . The margin of borderline and malignant subtypes were not sharp and smooth, but benign ones were smooth （P=0.012） . Seventeen tumors had MR images, 12 lesions were shown with high signal intensity on T2WI, and 8 of them were with higher bright cystic area. Borderline and malignant lesions were shown with low signal internal septations on T2WI （p=0.021） , and the same appearance on enhanced imaging （P=0.028） . Conclusion： Phyllodes tumors of breast have certain characteristics on mammography and MRI. The features on T2WI and enhancement imaging were valuable for the judgment of pathological subtype of the tumor.