乳腺癌组织类型的动态增强MRI鉴别诊断  

Histopathological types of breast differentiated by the dynamic contrast-enhanced magnetic resonance imaging

作　　者：马凤华[1,2] 赵泽华[1,2] 刘文瑾[1,2] 李莉[1,2] 

机构地区：[1]上海市普陀区中心医院 [2]上海中医药大学附属普陀医院放射科,200062

出　　处：《上海医学影像》2011年第3期191-194,共4页Shanghai Medical Imaging

摘　　要：目的探讨乳腺动态增强MRI在不同病理类型乳腺癌鉴别诊断中的价值。方法回顾性分析45例经病理证实的乳腺癌患者MRI资料,所有患者术前均行动态增强MRI,绘制时间-信号强度曲线,计算不同时期强化率,并用单因素方差分析进行统计学分析。结果 45例乳腺癌中,29例为浸润性导管癌,6例为黏液腺癌,4例乳头状癌,4例浸润性筛状癌和2例髓样癌。时间-信号强度曲线显示:Ⅲ型曲线为31例(68.9%),Ⅱ型曲线9例(20.0%),Ⅰ型曲线5例(11.1%)。浸润性筛状癌与黏液腺癌的早期强化率差异有统计学意义,增强后2、3期浸润性筛状癌与乳头状癌增强率差异有统计学意义。结论不同类型乳腺癌因其病理基础不同,表现出不同的MRI特征,动态增强MRI对不同类型乳腺癌的鉴别诊断有一定参考价值。Objective To demonstrate the features of different breast carcinomas by DCE-MRI.Methods Using a retrospectively database,45 patients with breast carcinoma surgicopathology were conducted.All patients underwent dynamic enhanced scanning.Time intensity curves（TICs） were obtained from the regions showing maximal enhancement in the enhanced images and classified as monophasic（typeⅠ）,biphasic（typeⅡ）,or washout（typeⅢ） according to their shapes.The enhancement rate of differential time was observed and compared by one-way analysis of variance（ANOVA）.Results There were 29 cases of the ductal carcinomas,6 cases of the mucinous carcinomas,4 cases of the papillary carcinomas,4 cases of the cribriform carcinomas and 2 cases of the medullary carcinomas.The maximum diameter of the lesions ranged from 1 to 8.1 cm.Of the 45 patients TICs were showed as type Ⅲ in 31 cases（68.9%）,type Ⅱin 9 cases（20.0%）,and type Ⅰ in 5 cases（11.1%）.A significant difference was found between the cribriform carcinoma and the mucinous carcinoma in the early enhancement rate.A significant difference was found between the cribriform carcinoma and the papillary carcinoma in the enhancement rate of the second and the third date.Conclusion DCE-MRI can offer additional morphological information about different breast carcinomas and improve our ability to differentiate the histopathological type of breast carcinoma.

关 键 词：乳腺癌 磁共振成像 动态增强 弥散加权成像 

分 类 号：R737.9[医药卫生—肿瘤]