动态磁共振成像在乳腺癌保乳术中的术前评估作用  

Role of Dynamic Magnetic Resonance Imaging in Preoperative Evaluation of Breast Conserving Surgery for Breast Cancer

作　　者：范培芝[1] 张超杰[1] 刘鹏[2] 张志功[3] 唐梅徕[1] 顾晓文[1] 郑维[1] 李艳春[4] 

机构地区：[1]湖南省人民医院乳甲外科,湖南长沙410005 [2]湖南省人民医院放射科,湖南长沙410005 [3]湖南省人民医院胸外科,湖南长沙410005 [4]湖南省人民医院病理科,湖南长沙410005

出　　处：《医学临床研究》2012年第4期643-646,共4页Journal of Clinical Research

基　　金：长沙市科技局资助课题,编号：K0802134-31

摘　　要：[目的]评价动态增强磁共振成像（MRI）在乳腺癌保乳根治术的术前评估作用.[方法]平均年龄35.8岁的65 例女性乳腺癌患者,术前均行钼靶及MRI检查,对钼靶、MRI评估是否可行保乳手术进行分析,通过病理诊断来评价MRI在评估乳腺癌多中心病灶以及切缘范围上的准确性.[结果]65例患者中,钼靶术前评估认为可保乳术患者64.6%,低于MRI评估的83.1%,且两者相比差异有显著性（P＜0.05）.对癌块切缘判断准确率MRI为80%,显著高于钼靶的53.8%（P＜0.05）.[结论]在中青年女性的I^IIb期乳腺癌保乳术的术前评估方法中,动态增强MRI成像较钼靶更能准确判断有无多中心病灶及肿块切缘范围,更有利于决定是否采取保乳手术和更准确地判断手术切缘.[Objective]To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging （MRI） in preoperative evaluation of breast-conserving surgery for breast cancer. [Methods] Totally 65 female breast cancer patients with the average age of 35.8 years old took preoperative mammography and MRI examination. Mammography and MRI examination were used to evaluate the feasibility of breast-conserving surgery. Pathological diagnosis was used to evaluate the accuracy of MRI in the assessment of breast cancer in cutting edge and with multi-center lesions. [Results] Among 65 patients with breast cancer, 64.6% of the patients could undergo breast-conserving surgery by mammography preoperative evaluation which was lower than that by MRI evaluation（83.1%）, and there was significant difference between them（ P d0.05）. The accuracy rate of cancer mass margin by MRI was 80 %, which was significantly higher than that by mammography（53.8 % ） （ P 〈0.05）. [Conclusion] Dynamic contrast-enhanced MRI in the preoperative evaluation of young women with stage I- IIb breast cancer undergoing breast conserving surgery can more accurately determine multicenter lesion and incisal margin range than mammography, and is more helpful for deciding whether to adopt breast conserving surgery and more precisely determine surgical margin.

关 键 词：乳腺肿瘤/外科学 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]