摘要
目的 探讨乳腺导管原位癌的磁共振成像(MRI)特点及诊断价值.方法 参照乳腺影像报告和数据系统(BI-RADS)标准,回顾性分析80例乳腺导管原位癌患者的MRI表现.结果 MRI诊断为良性31例,恶性49例.MRI诊断乳腺导管原位癌的符合率为61.2%(49/80),其中肿物型诊断符合率为80.0%(16/20),高于非肿物型的55.0%(33/60)(χ2=3.95,P<0.05).肿物型20例,形态呈圆形7例(35.0%),分叶状6例(30.0%),不规则型7例(35.0%);边缘清楚7例(35.0%),不规整12例(60.0%),毛刺1例(5.0%);肿物均匀强化7例(35.0%),边缘强化7例(35.0%),内部分隔强化6例(30.0%);时间-强度曲线呈Ⅰ型3例(15.0%),Ⅱ型9 例(9/20,45.0%),Ⅲ型8例(40.0%).非肿物型60例,均匀强化6例(25.0%),不均匀强化24例(30.0%),点状强化3例(5.0%),丛状环形强化27例(45.0%);强化分布呈局灶样15例(25.0%),导管样3例(5.0%),区段样24例(40.0%),区域样18例(30.0%);时间-强度曲线呈Ⅰ型20例(33.3%)、Ⅱ型31 例(51.7%)、Ⅲ型9例(15.0%).结论 MRI对肿物型乳腺导管原位癌诊断符合率高于非肿物型,非肿物型乳腺导管原位癌的主要表现是区段、区域样分布的丛状或不均匀强化,时间-强度曲线以平台型居多.
Objective To investigate the magnetic resonance imaging (MRI) characteristics of breast ductal carcinoma in situ (DCIS). Methods A retrospective analysis of MRI features in 80 breast DCIS patients was performed according to breast imaging reporting and data system (BI-RADS). Results Thirty-one patients were diagnosed benign by MRI, 49 cases were diagnosed malignancy. Of the 20 mass-like lesions, 7 cases (35.0%) were round, 6 cases (30.0%) were lobulated, 7 cases (35.0%) were irregular. The coincidence rate of MRI in detecting mass-like and non-mass-like lesions was 80.0% and 55.0% (P〈0.05), respectively. Seven cases (35.0%) had distinct margins, 12 cases (60.0%) had indistinct margins and 1 case (5.0%) had spiculated margins. Seven cases (35.0%) showed internal homogeneous enhancement, 7 cases (35.0%) had ring enhancement and 6 cases (30.0%) had septal enhancement. TypeⅠ, Ⅱ, and Ⅲ time-signal intensity curve (TIC) was identified in 3,9 and 8 lesions, respectively. 6 cases(10.0%) were homogeneous enhancement, 24 cases (40.0%) were heterogeneous enhancement, 3 cases (5.00%) were punctate enhancement and 27 cases (45.0%) were clumped enhancement. TypeⅠ, Ⅱ, and Ⅲ TIC was observed in 20, 31 and 9 lesions, respectively. Conclusion MRI is effective on detecting mass-like lesions. In non-mass-like lesions, clumped or heterogeneous enhancement of segmental or regional lesion is the main MRI feature.
出处
《中国医药》
2014年第3期364-368,共5页
China Medicine
关键词
乳腺肿瘤
癌
原位
磁共振成像
诊断
Breast neoplasms
Carcinoma in situ
Magnetic resonance imaging
Diagnosis