乳腺导管原位癌的MRI特征性强化与病理分级对照

The Distinctive MRI Enhancement Performance of Ductal Carcinoma in Situ(DCIS) and the Comparative Analysis with Pathological Grading

目的本研究探讨乳腺导管原位癌(DCIS)的MRI非肿块样强化表现,并分析其与病理亚型间的相关性,提高DCIS的诊断敏感性及准确性。方法回顾性分析58例经手术病理证、且MRI检查呈非肿块样强化的乳腺DCIS病例,以病理为金标准,作对照分析。结果 58例DCIS非肿块样强化中,(1)强化形态:段样强化32例(55.2%),导管分支样强化12例(20.7%),局灶性强化9例(15.5%),区域性强化4例(6.9%),弥散性强化1例(1.7%)。(2)内部强化方式:不均匀强化17例(29.3%),成簇小环状21例(36.2%),网格状10例(17.2%),丛状7例(12.1%),均匀强化3例(5.2%)(3)58例DCIS病例中,病理Ⅰ级(低级别)10例(17.2%),Ⅱ级(中级别22例(37.9%),Ⅲ级(高级别)26例(44.8%)。(4)58例DCIS病例中,共绘制动态增强曲线51例:Ⅰ型18例(35.3%),Ⅱ型25例(49%),Ⅲ型8例(15.7%)。其中非肿块样强化形态与病理分级对照X2检验中,段样强化X2值为6.07,P<0.05,导管样强化X2值为6.57,P<0.05具有统计学意义。结论乳腺导管原位癌MRI非肿块样强化特征是以段样、导管样强化表现为主,并能提示病理分级,(P<0.05)具有统计学意义。

Objective To investigate the non-mass like enhancement of DCIS, and analyzed the correlation between the pathological subtype and non-mass like enhancement, in order to improve the sensitivity and accuracy of breast diagnosis DCIS. MaterialsandMethods 58 cases of DCIS which confirmed by surgery pathology were retrospectively analyzed, MRI results were compared with pathological data which was regarded as the gold standard. Results MRI images of 58 cases of DCIS than mass sample reinforcement,（1）Strengthen the form：Section of the sample improved 32 cases （55.2%）, Sample tube improved 12 cases 20.7%）, Focal improved 9 cases （15.5%）, Regional improved 4 cases （6.9%）, Diffuse improved in 1 case （2%）.（2）In 58 cases of DCIS, Pathology of low level 10 cases （17.2%）, Level in 22 cases （37.9%）,High levels of 26 patients （44.8%）.（3）In 58 cases of DCIS, Dynamic enhancement curve typeⅠ21 cases （36.2%）,Ⅱtype 27 cases （46.6%）,Ⅲtype 9 cases （15.5%）. （4） in 58 cases of DCIS, a total of 51 cases with dynamic enhancement curves：Ⅰ18 cases （35.3%）, typeⅡ25 cases （49%）,Ⅲtype 8 cases （15.7%）. Conclusion The MRI enhancement performance of Mammary gland ductal carcinoma in situ is section like, catheter like, and which prompt pathologic stage.