肿块型三阴性乳腺癌3.0T MRI特征

3.0T MRI features of mass-like triple negative breast cancer

目的:探讨肿块型三阴性乳腺癌的3.0T MRI特征。方法:回顾性分析2016年9月—2019年9月在汕头市中心医院接受乳腺MRI检查并确诊乳腺癌的156例患者术前3.0T MRI资料,共159个病灶,其中Luminal A型病灶41个,Luminal B型病灶70个,HER-2过表达型病灶24个,三阴性病灶24个。比较各分子亚型乳腺癌的形状、边缘、内部强化特征、早期强化率、时间—信号强度曲线(TIC)类型、达峰时间、最大强化率、T2WI信号、表观弥散系数、病灶最大径的差异。结果:三阴性乳腺癌形状表现为类圆形的分别是Luminal A型、Luminal B型、HER-2过表达型的6.9倍(95%CI:2.116~22.458)、9.2倍(95%CI:3.081~27.226)、27.2倍(95%CI:3.144~235.021);边缘表现清晰的分别是Luminal B型、HER-2过表达型的13.4倍(95%CI:4.059~44.373)、15.0倍(95%CI:3.639~61.832);T2WI表现为稍高或高信号的分别是Luminal A型、Luminal B型、HER-2过表达型的45.4倍(95%CI:8.796~234.082)、25.7倍(95%CI:5.529~119.144)、33.0倍(95%CI:5.925~183.786);TIC类型表现为流出型的分别是Luminal A型、HER-2过表达型的4.3倍(95%CI:1.254~14.872)、4.2倍(95%CI:1.107~16.167)。结论:肿块型三阴性乳腺癌3.0T MRI常表现为边缘清晰的类圆形肿块、T2WI呈稍高或高信号、TIC类型为流出型,对临床诊断及治疗方案的选择具有一定价值。

Objective:To investigate the 3.0T MRI features of mass-like triple negative breast cancer.Methods:The data of 156 patients with breast cancer diagnosed by breast 3.0T MRI in Shantou Central Hospital from September 2016 to September 2019 were retrospectively analyzed.There were 159 lesions,including 41 Luminal A lesions,70 Luminal B lesions,24 HER-2 overexpression lesions,and 24 triple negative lesions.The shape,margin,internal enhancement characteristics,early enhancement rate,time-signal intensity curve(TIC)type,peak time,maximum enhancement rate,signal intensity on T2-weighted imaging(T2WI),apparent diffusion coefficient and maximum diameter of the lesions of various molecular subtypes of breast cancer were compared.Results:The triple negative breast cancers with a round shape were 6.9 times(95%CI:2.116-22.458),9.2 times(95%CI:3.081-27.226)and 27.2 times(95%CI:3.144-235.021)of Luminal A,Luminal B,and HER-2 overexpression breast cancers subtype respectively.The triple negative breast cancers with clear margins were 13.4 times(95%CI:4.059-44.373)and 15.0 times(95%CI:3.639-61.832)of Luminal B and HER-2 overexpression breast cancers subtype,respectively.The triple negative breast cancers with slightly high or high signal on T2WI were 45.4 times(95%CI:8.796-234.082),25.7 times(95%CI:5.529-119.144)and 33.0 times(95%CI:5.925-183.786)of Luminal A,Luminal B,and HER-2 overexpression breast cancers subtype respectively.The triple negative breast cancer with TIC type as outflow type were 4.3 times(95%CI:1.254-14.872)and 4.2 times(95%CI:1.107-16.167)of Luminal A and HER-2 overexpression breast cancers subtype,respectively.Conclusion:The 3.0T MRI of mass-like triple negative breast cancer often presents as a roundshaped mass with clear margins,slightly higher or high signal on T2WI,and outflow type of TIC,which has certain value for clinical diagnosis and treatment options.