乳腺硬化性腺病的MR影像表现及与X线、病理对比分析

Sclerosing adenosis of breast MR imaging comparative analysis with X-ray and pathological findings

目的:探讨乳腺硬化性腺病的MR影像特征,并与钼靶X线及病理表现相对照,总结经验,降低临床误诊率。方法:收集2013年1月—2016年6月经手术证实的硬化性腺病150例,其中34例均于术前一周内行MR和钼靶检查,分析34例的MR、钼靶X线影像表现并与病理改变对比分析。结果:34例MR图像单侧发病30例(88.2%),双侧发病4例(11.8%),肿块样强化22例(64.7%),非肿块样强化10例(29.4%),点状及无明显强化2例(5.9%)。TIC曲线Ⅰ型14例(41.2%),Ⅱ型18例(52.9%),Ⅲ行2例(5.9%)。ADC值> 1.1×10^(-3)s/mm^2者32例(94.1%),<1.1×10^(-3)s/mm^2者2例(5.9%)。钼靶X线:肿块或结节状影24例(70.6%),其中合并钙化8例(23.5%),无钙化16例(47.1%);结构扭曲10例(29.4%),其中合并钙化8例(23.5%),无钙化2例(5.9%)。病理结果:单侧发病28例(82.4%),双侧发病6例(17.6%)。SA合并良性病变20例(58.8%),合并恶性病变8例(23.5%),合并不典型增生7例(20.6%),合并放射状瘢痕3例(8.8%),复杂性硬化性病变5例(14.7%)。结论:硬化性腺病MR影像表现缺乏特异性,以不规则肿块样强化及局域性集丛样、区域性强化多见,TIC曲线以Ⅰ型多见。

Objective To investigate the MR imaging features of sclerosing adenosis of breast, and with mammography image and pathological contrast, summarize the experience, reduce the misdiagnosis rate. Methods Sclerosing adenosis were collected from January 2013 to June 2016 which confirmed by surgrey operation, of which 34 cases were performed MR and X-ray examination before operation, analysis of 34 cases of MR, mammography imaging and pathology analysis and comparison. Results 30 cases of unilateral MR images(88.2%), 4 cases of bilateral disease(11.8%), where in the mass like enhancement in 22 cases(64.7%), non mass like enhancement in 10 cases(29.4%), spot and no enhancement in 2 cases(5.9%).TIC curve type into type Ⅰ 4 cases(41.2%), type Ⅱ 18 cases(52.9%), 2 cases of type Ⅲ outflow line(5.9%). 32 cases of ADC > 1.1×10-3 mm2/s(94.1%), 2 cases of < 1.1×10-3 mm2/s(5.9%). Mammography image: mass or nodular shadows in 24 cases(70.6%), including 8 cases with calcification(23.5%), without calcification in 16 cases(47.1%);(29.4%) the structure distortion in 10 cases, including 8 cases with calcification(23.5%), without calcification in 2 cases(5.9%). The pathological results: 28 cases of unilateral disease(82.4%), 6 cases of bilateral incidence(17.6%).SA and 20 cases of benign lesions(58.8%), and 8 cases of malignant lesions(23.5%), with 7 cases of atypical hyperplasia(20.6%), 3 cases with radial scar(8.8%), the complex sclerosing lesion in 5 cases(14.7%). Conclusion Sclerosing adenosis MR manifestations of lack of specificity, irregular mass enhancement and localized in cluster, regional uneven enhancement to see more, TIC curve type Ⅰ is more.