乳腺叶状瘤的X线及MRI表现  

Phyllodes Tumors of the Breast:Mammography and MRI Features

作　　者：孙宗琼[1] 陈林[1] 邵婉仪[1] 贺锋[1] 丁勇俊[1] 岳建国[1] 

机构地区：[1]江苏省无锡市第四人民医院(市肿瘤医院)放射科,214000

出　　处：《临床放射学杂志》2013年第2期184-187,共4页Journal of Clinical Radiology

摘　　要：目的探讨乳腺叶状瘤(PT)X线和MRI的影像学特征,以提高其影像诊断和鉴别诊断水平。方法回顾性分析经手术、病理证实的30例PT患者的临床及影像资料,其中22例行X线检查,19例行MRI。结果 30例均为单发,表现为乳腺内直径1.5～21 cm(平均6.2 cm)的肿块;22例行乳腺X线检查者,病灶表现为圆形(5例)或分叶状(17例)、密度高于邻近腺体的肿块,边界清楚(16例)或部分不清(6例),所有病例均未发现钙化及邻近皮肤增厚、乳头回缩、周围乳腺结构扭曲等恶性征象。行MRI的19例患者,病灶表现为圆形(7例)或分叶状(12例),T1WI上呈等信号(8例)或低信号(11例),信号均匀(12例)或不均匀(7例),出现囊变或分隔(5例)、出血(2例);19例肿瘤T2WI上均为高信号,动态增强后时间-信号强度曲线(TIC)呈平台型16例,轻度流出型3例。30例PT病理诊断:Ⅰ级14例,Ⅱ级10例,Ⅲ级6例。结论 PT的影像学表现有一定的特点,尤其MRI动态增强扫描对诊断有重要价值,但其良恶性的判定仍有赖于组织病理学检查。Objective To evaluate the mammography and MRI features of phyllodes tumors （PT） in breast,and to im- prove diagnosis accuracy. Methods The clinic and image data of PT （ n = 30 ） confirmed by surgery and histopathology were retrospectively analyzed. 22 patients and 19 patients performed mammography and MRI examination respectively. Re- sults 30 tumors showed spheroid mass in breasts ranged from 1.5 cm to 21 cm in diameter（ average 6.2 cm） , Mammogra- phy revealed round （ n = 5 ） or lobulated （ n = 17 ） masses with high density（ compared with surrounding fibroglandular breast tissue） in 22 patients. 16 of 22 tumors had well defined margins. No evidence of calcification and malignant signs, such as skin thickening,nipple retraction or distortion of perifocal structures was detected. On MRI imagings, 19 cases showed round （ n = 7 ） or lobulated （ n = 12 ） masses. Lesions showed middle signal （ n = 8 ） or low signal （ n = 11 ） on T~ WI, and cystic de- generation founded in 5, hemorrhage in 2 on T^WI, all lesions presented high signal on T2WI. The time signal intensity curves（TIC） of 16 tumors were plateau and 3 tumors were slightly washout after dynamic contrast enhancement（DCE-MRI） administration. The pathologic results of 30 tumors were grade i inl4, gradeⅡ in 10 , and grade Ⅲ in 6. Condusion Mammography and MRI manifestations of phyllodes tumors have characteristics. DCE-MRI has great value in diagnosing the disease, but the final diagnosis of PT still depends on the histopathologic examination.

关 键 词：乳腺肿瘤 叶状瘤 X线摄影术 磁共振成像 乳腺 

分 类 号：R737.9[医药卫生—肿瘤]