乳腺浸润性小叶癌的动态增强MR表现

Dynamic contrast-enhanced MRI features of invasive lobular breast carcinoma

目的探讨乳腺浸润性小叶癌的MRI表现。方法回顾性分析18例经病理证实为浸润性小叶癌的MRI图像资料,观察其形态、边缘,并生成动态增强曲线。结果 18例中,1例未见乳房病灶,11例呈肿块样强化,6例呈非肿块样强化;11例肿块样强化灶均表现出边缘不规则或毛刺分叶等特征;11例表现为多发病灶,6例表现为单发病灶。多发病灶中,5例表现为多发的斑片状或(微)小结节状强化灶聚集分布,其中3例部分强化灶之间见线条状强化影相连。动态曲线上,3例流入型强化,8例平台型强化,6例流出型强化。MIP图像上6例出现患侧血管征阳性。结论动态增强MRI对乳腺浸润性小叶癌的诊断具有较高价值,多表现为边缘不规则或带分叶毛刺的肿块样强化。多发聚集分布的强化病灶较具特征性。

Objective To investigate the Mill features of invasive lobular breast carcinoma. Methods MRI was retrospectively analyzed for the morphology and contrast enhancement kinetics of 18 pathologically confirmed invasive lobular breast carcinomas. Results The lesions were multiple foci of mass-like enhancement with irregular, spiculated or lobulated margins （ 11 ） or solitary non-mass-like enhancement （6）. MRI was normal in 1 patient. Several patchy or micronodular enhancing lesions were seen in 5/11 patients with linear enhanced connections between the lesions （3）. Kinetics included type one （3）, type two （8）, and type three （6） curves. On maximum intensity projection images, increased vascularity was detected in 6 lesions. Conclusion Dynamic contrast-enhanced MRI is valuable in the diagnosis of breast invasive lobular carcinoma with predominant characteristic appearance of grouped irregular or spiculated mass-like enhancing lesions.