不同病理级别的乳腺叶状肿瘤MRI成像分析

MRI Analysis of Breast Phyllodes Tumor at Different Pathological Levels

目的分析比较不同病理级别乳腺叶状肿瘤的MRI表现,提高对该病的MRI诊断能力。方法搜集经手术病理证实的乳腺叶状肿瘤39例,按良性、交界性、恶性分成三组,根据ACR乳腺影像报告和数据系统(BIRADS),采用卡方检验及方差分析进行比较分析不同病理级别的乳腺叶状肿瘤的形态学特点、平扫信号特点、强化表现以及临床特征。结果 39例叶状肿瘤中,良性7例,交界性22例,恶性10例。三组间肿块形态、分隔、T2WI低信号裂隙等征象差异无明显统计学意义(P=0. 454、0. 156、0. 204)。交界性及恶性叶状肿瘤主要表现为边界不清、强化不均匀及囊变;良性叶状肿瘤主要表现为边界清晰、强化均匀、未见囊变。边界、强化表现、囊变差异具有统计学意义(P=0. 004、0. 001、0. 02)。结论应用BI-RADS判读乳腺叶状肿瘤的MRI征象,进一步提高不同病理级别叶状肿瘤的诊断能力以及指导临床选择相应的处理方案。

Objective To analyze and compare the MRI findings of breast phyllodes tumors at different pathological grades in order to improve the MRI diagnosis ability of the disease.Methods A total of 39 cases of breast phyllodes tumors confirmed by surgery and pathology from January 2015 to June 2016 in Fudan University Affiliated Tumor Hospital were divided into three groups according to benign,borderline and malignant.According to ACR mammography report and data system(BI-RADS)The chi-square test and analysis of variance were used to compare and analyze the morphological characteristics,plain signal characteristics,enhanced performance and clinical features of breast phyllodes tumors with different pathological grades.Results Of the 39 phyllodes tumors,7 were benign,22 were borderline,and 10 were malignant.There were no significant differences in the morphology,separation,and T2 WI low signal fissure between the three groups(P=0.454,0.156,0.204).Borderline and malignant phyllodes tumors are mainly characterized by unclear borders,intensified intensification,and cystic changes.Benign phyllodes tumors are characterized by clear borders,uniform enhancement,and no cystic changes.Boundary difference,enhancement,and cystic changes were statistically significant(P=0.004,0.001,0.02).Conclusion The MRI features of breast phyllodes tumors were interpreted by BI-RADS to further improve the diagnostic ability of phyllodes tumors of different pathological grades and to guide the corresponding treatment options for clinical selection.