乳腺导管原位癌的MRI分析  

MR Imaging Analysis of Ductal Carcinoma in Situ of the Breast

作　　者：闵庆华[1,2] 许玲辉[1] 彭卫军[1] 杨军[2] 杨宝锋[1] 王春桃[3] 

机构地区：[1]复旦大学附属肿瘤医院放射科,上海200032 [2]上海市长宁区中心医院影像科 [3]河南焦作市第二人民医院放射科

出　　处：《实用放射学杂志》2010年第11期1643-1646,共4页Journal of Practical Radiology

摘　　要：目的 分析乳腺导管原位癌（DCIS）的MR形态特征,提高术前诊断的准确性.方法 经手术、病理证实的乳腺导管原位癌20例,导管原位癌伴微浸润14例,根据BI-RADS数据系统从病灶分布形式和内部强化特征进行回顾性分析.结果 34例患者中MR检出34个DCIS.其中非肿块性强化30个,肿块性强化4个.在非肿块性强化中,以段样分布13个（43.3%）,区域性分布5个（16.7%）,簇状分布4个（13.3%）, 分支导管样强化6个（20%）,线样导管样强化2个（6.7%）.内部强化中成群强化11个（45.8%）,均匀强化5个（20.8%）,不均匀强化8个（33.3%）,6个分支导管样强化不作归类.肿块性强化的4个,均 呈类圆形,分叶、毛刺,直径约1.5～2 cm;强化不均匀3个,边缘强化1个,3个肿块性强化病灶时间-增强曲线呈廓清型曲线.结论 段样、分支导管样分布,成群强化在DCIS的诊断中具有特征性意义.Objective To analyse MR imaging morphological characteristics of ductal carcinoma in situ（DCIS） of the breast. Methods 20 cases with pathologically proved DCIS（14 cases with focus infiltrating） were retrospectively reviewed on the basis of breast imaging reporting and data system . Results 34 DCISs were found in 34 patients . On contrast-enhanced MR imaging,30 lesions showed non-mass-like enhancement and 4 lesions showed mass-like enhancement. Among the morphologic findings in non -- mass--like enhancement , 13 lesions were segmental distribution（43.3% ）, 5 were regional distribution （16.7%） and 4 were focal distribution（13.3%） . 6 lesions appeared as branching--ductal enhancement （20%）and 2 appeared as linear--ductal enhancement （6.7%） enhancement . 11 lesions showed clumped internal architecture（45.8%） , 5 showed homogeneous enhancement（20.8%） and 8 showed heterogeneous enhancement（33.3 %） . However,the 6 lesions which showed branching--duetal enhancement were not be categorized. The 4 lesions with mass--like enhancement showed similar circle,lobulated and burr, the diameter of masses was 1.5 2 cm. The heterogeneous internal enhancement and borderline enhancement was seen in 3 lesions and one lesion, respectively Conclusion The segmental distribution, branching--ductal and clumped internal architecture on MR images are considered as the characteristic features in diagnosis of DCIS.

关 键 词：乳腺 乳腺导管原位癌 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]