乳腺乳头病变的MRI特点

The MR imaging features of breast nipple diseases

目的:回顾性分析良恶性乳头病变的乳腺MRI特点,以提高诊断正确率。方法:搜集2012年9月-2015年9月本院经手术病理证实且术前行MRI检查的13例乳头病变患者的病例资料,分析病灶的形态学特征及强化特点。所有病例MRI表现由2名从事乳腺影像诊断的放射科医师共同阅片,讨论达成一致诊断意见。结果:13例患者的病理结果分别为:软纤维瘤2例,乳头腺瘤2例,乳腺炎性病变累及乳头3例,乳头派杰病(PD)6例。在MRI上,2例乳头软纤维瘤均表现为乳头上小结节,轻度强化。2例乳头腺瘤MRI表现为乳头增大伴乳头内强化结节。3例乳头炎性病变中,1例MRI上表现为乳头内环形强化结节,乳腺内未见异常强化;另外2例MRI上表现为乳头轻度或明显异常强化,乳腺内可见异常强化炎性灶。6例乳头PD中,乳腺内均有异常强化恶性病灶;其中5例MRI上表现为患侧乳头明显不均匀强化,另1例患侧乳头未见异常强化。结论:乳腺乳头病变在MRI上多发表现为乳头内强化结节或乳头不均匀强化,结合乳头病变强化特点及乳腺内有无可疑恶性病灶,有助于鉴别诊断。

Objective：The purpose of this study was to evaluate magnetic resonance imaging （MRI） features of benign and malignant nipple diseases in order to improve the diagnostic accuracy. Methods： Thirteen patients with pathologically confirmed nipple diseases in our hospital between September 2012 and September 2015 was retrospectively studied. All the patients underwent MRI examination before operation. Morphological characteristics and dynamic contrast enhancement characteristics of the lesions were reviewed. MRI features of all the lesions were reviewed by two radiologists specialized in breast diseases in consensus. Results：The pathological results of the 13 patients were soft fibroma （n 2） ,nipple adenoma （n=2）, breast inflammatory diseases involved the nipple （n=3）, and paget disease （PD, n= 6）. On MRI, the two cases of nipple soft fibroma showed small nodules in the nipple with slight enhancement. The two cases of nipple adenoma presented as nipple enlargement with enhanced nodules inside the nipples. As for the three cases of inflammatory diseases involved the nipple,one showed a rim-enhanced nodule inside the nipple,and no additional abnormal enhancement was found in the same side breast. The other two presented as slightly or remarkably enhanced nipples. Furthermore, abnormal enhanced inflamma tory lesions were detected in the breast parenchyma. Suspicious enhanced lesions in the breast were found in all the six cases of PD, five of them revealed abnormal enhancement in the involved nipples,and the other one showed no abnormal enhancement. Conclusion：On MRI, nipple diseases commonly show as an enhanced nodule or heterogeneous enhancement of the whole nipple. It is helpful to make a differential diagnosis by combining the enhancement features of the nipple lesions with or without the suspicious malignant enhanced lesions in the breast parenchyma.