3.0T MR动态增强扫描在鉴别乳腺导管原位癌有无微浸润中的价值  

The value of dynamic contrast-enhanced imaging at 3.0T MR examination in differentiation between micro-invasive ductal carcinoma in situ and pure ductal carcinoma in situ of the breast

作　　者：李相生[1] 李德昌[2] 王萍[1] 祝红线[1] 樊红霞[1] 宋云龙[1] 方红[1] 

机构地区：[1]中国人民解放军空军总医院磁共振科,北京100142 [2]中国人民解放军空军总医院病理科,北京100142

出　　处：《现代肿瘤医学》2014年第11期2617-2621,共5页Journal of Modern Oncology

摘　　要：目的:探讨3.0T MR动态增强扫描在鉴别乳腺导管原位癌有无微浸润中的价值。方法:研究纳入了经手术或活检证实的52例导管原位癌,按照病理结果分为两组,即单纯导管原位癌组和导管原位癌伴微浸润组。对两组病变的多期动态增强表现进行回顾性对照分析,评价指标包括:强化形态、内部强化特点及时间-信号强度曲线,并对有统计学显著性差异的影像学征象的鉴别诊断价值进行分析。结果:导管样强化多见于单纯导管原位癌组(P=0.01);节段样强化和肿块样强化多见于导管原位癌伴微浸润组(P=0.04,0.03);点簇样强化多见于导管原位癌伴微浸润组(P=0.02);均匀性强化多见于单纯导管原位癌组(P=0.04)。速升平台型曲线多见于单纯导管原位癌组(P=0.04),速升缓降型曲线多见于导管原位癌伴微浸润组(P=0.03)。病变强化形态的鉴别诊断价值要高于内部强化特点和时间-信号强度曲线,其敏感度、特异度及准确度为76.5%、70.2%和67.7%。结论:3.0T MR动态增强扫描有助于鉴别导管原位癌有无微浸润,尤其病变的强化形态对鉴别诊断有一定帮助。Objective：To investigate the value of dynamic contrast-enhanced imaging at 3.0T MR examination in differentiation between microinvasive ductal carcinoma in situ （DCIS） and pure DCIS of the breast.Methods：This study included 52 cases of DCIS confirmed with surgery or biopsy.These patients underwent dynamic contrast-enhanced MR examinations and were classified into two groups into pure DCIS group and micro-invasive DCIS group in light of pathologic results.The dynamic contrast-enhanced MR manifestations,including enhancement morphology,internal enhancement characteristics and time-intensity curve （TIC）,were retrospectively compared between two groups.For the imaging features which had statistical differences,the differentiation diagnostic values were analyzed.Results：Ductal enhancement pattern was mostly seen in pure DCIS（P =0.01）,and segmental enhancement pattern or masslike enhancement pattern was frequently seen in micro-invasive DCIS（P =0.04,0.03）.Clumped nodule enhancement was frequently seen in micro-invasive DCIS （P =0.02）.Homogeneous enhancement was frequently seen in pure DCIS（P =0.04）.TIC showing a rapid rise followed by a plateau was frequently seen in pure DCIS（P =0.04）,and TIC showing a rapid rise followed by a slow decline frequently seen in micro-invasive DCIS（P =0.03）.The differential diagnostic value of enhancement morphology was higher than that of internal enhancement characteristics or time-intensity curve,and differentiation diagnostic sensitivity,specificity and accuracy of enhancement morphology was 76.5%,70.2% and 67.7% respectively.Conclusion：Dynamic contrast-enhanced imaging at 3.0T MR examination is helpful for differentiation between pure DCIS and micro-invasive DCIS,and especially enhancement morphology plays an important part in differential diagnosis.

关 键 词：乳腺 导管原位癌 微浸润 磁共振成像 动态增强 

分 类 号：R737.9[医药卫生—肿瘤]