乳腺浸润性导管癌影像学表现与组织学分级的相关性

Correlations of imaging manifestations and histological grades of breast invasive ductal carcinoma

目的观察全视野数字化乳腺摄影(FFDM)联合乳腺断层摄影(DBT)及超声所见乳腺浸润性导管癌(IDC)征象与组织学分级的相关性。方法192例IDC经病理证实,其中8例组织学分级Ⅰ级、116例Ⅱ级、68例Ⅲ级;回顾性分析其FFDM联合DBT及超声表现,记录病灶大小、边界、形态、毛刺、恶性钙化、纵横比及有无可疑淋巴结转移,分析FFDM联合DBT以及超声所见与IDC组织学分级的关系。结果FFDM联合DBT对病灶形态不规则、毛刺、恶性钙化的检出率高于超声;超声对可疑淋巴结转移更敏感。组织学Ⅰ级、Ⅱ级IDC较Ⅲ级IDC更易出现毛刺征;超声更易检出组织学Ⅲ级IDC淋巴结转移。结论IDC影像学征象与组织学分级之间存在一定相关性;联合应用FFDM、DBT及超声观察IDC可在一定程度上为组织学分级提供依据。

Objective To investigate the correlations of imaging manifestations of full-field digital mammography(FFDM)and digital breast tomosynthesis(DBT)as well as ultrasound and histological grades of breast invasive ductal carcinoma(IDC).Methods Totally 192 IDC patients confirmed by pathology were enrolled,including histological gradingⅠ(n=8),Ⅱ(n=116)andⅢ(n=68),respectively.Imaging findings including FFDM combined with DBT and ultrasound were retrospectively analyzed.The size,boundary,morphology,burr and malignant calcifications and aspect ratio of lesions,as well as weather there was suspected lymph node metastasis were recorded,and the relationships of imaging manifestations and histological grades were analyzed.Results The detect rate of FFDM combined with DBT for irregular modality,burrs and malignant calcifications were higher than those of ultrasound.Ultrasound was more sensitive to suspected lymph node metastasis than FFDM and DBT.Histological gradeⅠandⅡIDC were more prone to be found with burrs than gradeⅢ,while histological gradeⅢIDC were more prone to be found with lymph node metastasis by ultrasound.Conclusion Imaging manifestations had certain correlations with histological grades of IDC.Combination of FFDM,DBT and ultrasound could provide evidences for histological grading of IDC on some degree.