乳腺导管内乳头状瘤的MRI诊断  

MRI diagnosis of the breast intraductal papilloma

作　　者：张仁知[1] 周纯武[1] 李静[1] 欧阳汉[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院影像诊断科,北京100021

出　　处：《磁共振成像》2014年第4期259-263,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的总结乳腺导管内乳头状瘤的MR影像特征,提高其MRI诊断水平。材料与方法与术后病理对照,回顾性分析我院76例(7例双侧乳腺患病,共83侧)乳腺导管内乳头状瘤患者的术前MR图像,总结该病变的形态学特点、内部强化方式、血液动力学特征及其在T2WI、扩散加权成像(DWI)上的信号特点。结果病变最大径为0.2~9.8 cm,平均1.3 cm。病变形态:类圆形51侧,椭圆形13侧,不规则形11侧,分叶状8侧。病变边界:清楚73侧,不清楚10侧。病变T2WI脂肪抑制的信号特点:等高混杂信号40侧,等信号34侧,高信号9侧。病变DWI信号特点:76例中3例(均为单侧乳腺病变)DWI失败;80侧病变:高信号59侧,等信号21侧;病变ADC值范围为0.82×10-3 mm2/s^1.42×10-3 mm2/s,平均ADC值为1.15×10-3 mm2/s(正常乳腺ADC范围为1.03×10-3 mm2/s^1.98×10-3 mm2/s,平均为1.53×10-3 mm2/s)。病变内部强化方式:均匀明显强化50侧,不均匀强化33侧。病变时间-信号强度曲线类型:流出型33侧,缓升型28侧,平台型22侧。病变伴有导管扩张16侧(其中囊实性者11侧)。结论乳腺导管内乳头状瘤的MRI表现具有以下特征:病灶多为边界清楚的圆形、类圆形均匀强化结节,T2WI以等高混杂或等信号为主,上述特征有助于正确诊断。Objective： To investigate the clinical characteristics of magnetic resonance imaging （MRI） for the breast intraductal papilloma, and to help improve the diagnostic accuracy of the MRI for this lesion. Materials and Methods：Postoperative pathology was used as the gold standard, a total of 76 patients with breast intraductal papillom were collected, including 7 patients with bilateral breast neoplasms. Clinical characteristics of the preoperative MRI image data were analyzed, including morphological features of the lesion, the signal characteristics of the lesion for T2WI and diffusion weighted imaging （DWI）, the internal reinforcement method, and the characteristics of hemodynamics. Results：The average largest diameter line of the lesions was 1.3 cm, range from 0.2 cm to 9.8 cm. Morphology of the lesions were summarized as follows：round 51 cases, elliptic 13 cases, irregularly shaped 11 cases, lobulated 8 cases. Seventy-three cases showed clear margin while the other 10 cases didn’t. For the fat suppressed signal on T2WI, the number of cases with mixed hyper-intensity, iso-intensity, and hyper-intensity was 40, 34 and 9, respectively. There were 3 patients with unilateral lesion didn’t get the DWI result, 59 cases showed hyper-intensity, and 21 cases showed iso-intensity on DWI. The average value of apparent diffusion coefifcients （ADC） of the lesions was 1.15×10-3 mm2/s, ranges from 0.82× 10-3 mm2/s to 1.42×10-3 mm2/s. Fifty cases showed homogeneous enhancement and the other 33 showed heterogeneous enhancement. For the type of time-signal intensity curve, numbers of platform, outflow and sustained ascending was 22, 33, and 28, respectively. There were 16 cases in association with duct dilatation, among which 11 cases were cystic and solid. Conclusions：The characteristics of the MRI for the breast intraductal papilloms generally present as round lesion with clear margin, mixed hyper-or iso-intensity on T2WI, and with homogeneous enhancement. All these characteristics are valuable for a

关 键 词：乳腺肿瘤 乳头状瘤 管内 磁共振成像 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]