乳腺癌磁共振动态增强扫描恶性征象分析

To analyze malignant signs of the breast cancer with dynamic contrast enhancement MRI

目的探讨乳腺癌磁共振动态增强扫描的恶性征象。方法回顾性分析经病理证实的乳腺癌患者48例(共54个病灶),观察病灶动态增强扫描特征,记录病灶增强扫描的形态、强化方式、瘤周有无异常扩张、血管及时间-信号强度曲线类型。结果 1)形态学:外形较规则7个(13.0%);不规则47个(87.0%),其中周边有毛刺征或尖角征40个(74.1%),边缘有分叶征29个(53.7%);2)强化方式:较均匀强化17个(31.5%);环形向心性强化28个(51.9%);导管样强化6个(11.1%);簇状强化3个(5.5%);3)时间-信号强度曲线类型:流出型28个(51.9%);平台型24个(44.4%);流入型2个(3.7%);4)其它恶性征象:淋巴结肿大13例(27.1%);乳头凹陷9例(18.7%);肿块相邻乳房皮肤增厚8个(14.8%);肿块周边出现血管扩张或截断6个(11.1%)。结论磁共振动态增强扫描可以同时显示病变的形态学特征与血流动力学特征,对乳腺癌的诊断具有非常重要的参考价值。

Objective To investigate malignant signs of the breast cancer by dynamic contrast enhancement MRI. Methods 48 breast cancer patients （ 54 lesions ） who were proved by pathology were analyzed retrospectively, observed the signs of lesions by dynamic contrast enhancement, recorded the contrast enhanced forms, enhancement patterns, abnormal dilated or normal blood vessels in pericancerous and the type of time-signal intensity curve. Results 1 ） The morphology ： 7 cases that shapes are regular （ 13.0% ）, 47 cases that shapes are not regular （87.0%）, 40 cases with burr sign or the sharp angle sign around （74.1%）, 29 cases with lobulated sign on the edge （53.7%） ;2） The enhanced patterns： 17 cases were uniformly enhanced （31.5%）, 28 cases were annular and centripetal enhanced patterns （51.9%）, 6 cases were duct-shape enhancement （ 11.1% ）, and 3 cases were clustered enhancement （5.5%） ;3 ） The type of time-signal intensity curve： 28 cases were outflowed type （51.9% ）, 24 cases were flatbed type （44.4%）, 2 cases were inflowed type （3.7%） ;4） Other malignant signs： 13 cases had lymphadenectasis （24.1%）, 9 cases had inverted nipples （ 18.7% ）, 8 cases had incrassated skins near Breast lumps （ 14.8% ）, 6 cases were that there are abnormally expanded blood vessels around the mass （ 11.1% ）. Conclusion The dynamic contrast enhancement MRI can show the morphological characteristics and the hemodynamic characteristics of the lesions at the same time, and it has very important referencing value for the diagnosis of breast cancer.