三阴性乳腺癌的钼靶X线及MRI表现

MR and Mammography Imaging Features of Triple Negative Breast Cancers

目的探讨三阴性乳腺癌(TNBC)的钼靶X线及MRI影像学表现特征。方法搜集经病理及免疫组织化学证实的57例TNBC,其中44例行钼靶X线摄影,7例行MR平扫及增强,6例行钼靶X线摄影及MRI检查。回顾性分析其钼靶X线及MRI表现,测量病灶的表观扩散系数(ADC)值,记录肿块动态增强的时间-信号强度曲线(TIC)类型。结果钼靶X线摄影在50例检查者中42例发现病灶,单纯肿块27例,肿块伴钙化11例,单纯钙化4例;肿块多呈类圆形或卵圆形,28例肿块边缘清楚、光滑。MRI上11例为单一肿块,2例为非肿块型,病灶在T1WI上呈低或中等信号,在T2WI上2例肿块较小者呈高信号,11例呈等高混杂信号;11例肿块型中,边缘光滑4例,5例均匀强化,3例呈环形强化,3例不均匀强化;平均ADC值为1.2×10-3mm2/s,8例TIC呈Ⅲ型。结论 TNBC的钼靶X线及MRI表现有一定特征性,提高对特征性表现的认识有助于术前作出正确诊断。

Objective To explore the features of the triple negative breast cancers（ TNBC） on mammography and MR imaging. Methods Fifty-seven cases with TNBC confirmed by pathology and immunohistochemistry were collected,of which 44 cases performed with mammography,7cases performed with MRI,6 cases performed both mammography and MRI. The imaging appearances were retrospectively analyzed. The apparent diffusion coefficient（ ADC） value of lesions was measured,and the type of dynamic enhancement time signal intensity curve（ TIC） was recorded. Results Forty-two cases were detected in mammography in 50 patients,of which 27 lesions were simple mass,11 lesion were mass with calcification and 4 lesions were simple calcification. Masses were round or oval in shape,of which 28 cases had clear and smooth edge. On MRI,11 cases were single mass,2 cases were non-mass type lesions. Lesions had hypo or iso-intensity signal on T1 WI,hyper-intensity signal in two small masses and mixed signal in 11 lesions on T2 WI. Among 11 masses,4lesions had smooth edge,5 cases showed homogeneous enhancement,3 cases showed ring enhancement and 3 cases showed heterogenous enhancement. The average ADC value was 1. 2 × 10- 3mm2/ s,8 cases showed the Ⅲ type TIC. Conclusion Mammography and MRI findings of TNBC have some characteristics which improve the understanding of this disease that will be helpful to make correct diagnosis before operation.