动态增强MRI对早期乳腺癌的诊断价值  

Value of dynamic enhanced MRI in the diagnosis of early breast cancer

作　　者：蔡庆[1] 沈玉英[1] 杜红娣[2] 许传虓[1] 顾培华[1] 徐建良[1] 付芳芳[3] 沈海林[3] 

机构地区：[1]南京医科大学附属苏州医院放射科,苏州市215001 [2]上海交通大学医学院苏州九龙医院影像中心 [3]苏州大学附属第一医院影像中心

出　　处：《江苏医药》2011年第12期1414-1416,F0003,共4页Jiangsu Medical Journal

基　　金：江苏省高校自然科学研究指导性计划项目(01KJD320027)

摘　　要：目的探讨动态增强MRI对早期乳腺癌的诊断价值。方法分析20例早期乳腺癌动态增强MRI资料。其中,导管内乳头状癌2例,导管原位癌4例,导管原位癌伴微浸润性12例,小叶原位癌2例。总结早期乳腺癌特征性MRI表现。结果 (1)病灶增强MRI形态特征:局灶性强化2例;导管样及段样强化8例;肿块状强化10例,其中的9例肿块边缘为毛刺及不规则,1例边缘光滑;边缘强化7例,其中的2例均匀中心强化,1例分隔强化。乳腺影像报告和数据系统(BI-RADS)分级:1级1例,3级2例,其余为4级或5级。(2)X线检查结果:阴性3例,微小簇状钙化5例,线样钙化2例,肿块6例,结构扭曲2例,斑片阴影2例。BI-RADS分级:1级3例,2级1例,3级2例,其余为4级或5级。(3)16例患者早期增强率≥60%,16例信号强度-时间(SI-Time)曲线为A型,3例为B型,1例为C型。结论早期乳腺癌MRI表现具有一定特征性,动态增强MRI联合X线可提高其诊断准确性。Objective To investigate the value of dynamic enhanced magnetic resonance imaging（MRI） in the diagnosis of early breast cancer.Methods The dynamic enhanced MRI features of 20 cases with early breast cancer confirmed by operation and pathology were analyzed retrospectively.Of 20 cases,2 cases were intraductal papillary carcinoma,4 cases were ductal carcinoma in situ（DCIS）,12 cases were DCIS with small invasive foci,2 cases were lobular carcinoma in situ.The characteristic MRI features of early breast cancers were summarized.Results（1）Dynamic enhanced MRI morphology features of the lesions were focal enhancement in 2 cases,segmental and ductal-like enhancement in 8 cases,mass-like enhancement in 10 cases（spiculated and irregular margins in 9 cases and smooth in 1 case）,peripheral enhancement in 7 cases,center enhancement in 2 cases,and separation enhancement in 1 case.By X-ray,BI-RADS graded grade 1 in 1 case,grade 3 in 2 cases,grade 4 or 5 in the other cases.（2）The results of X-ray examination in 20 cases were negative in 3 case,small clusters of calcification in 5 cases,line of calcification in 2 cases,masses in 6 cases,structural distortion in 2 cases,shadow plaques in 2 cases.MRI BI-RADS graded grade 1 in 3 cases,grade 2 in 1 case,grade 3 in 2 cases,grade 4 or 5 in the other cases.（3）Early enhancement rate in 16 cases was more than 60%.Signal intensity-time（SI-Time）curve was type A in 16 cases,type B in 3 cases and type C in 1 case.Conclusion The early breast cancer has a certain characteristic dynamic enhanced MRI.MRI combined with X-ray examination may improve the accuracy in diagnosing early breast cancer.

关 键 词：乳腺癌 磁共振成像 动态增强 

分 类 号：R445[医药卫生—影像医学与核医学]