MRI引导定位活检对隐匿性乳腺癌的诊治价值  

Value of MRI-guided breast localization and biopsy in occult breast cancer

作　　者：赵玉年[1] 唐金海[2] 沈文荣[1] 郭震[1] 秦建伟[2] 李健[2] 顾慷[1] 王慧华[1] 庄珊 刘念龙[1] 

机构地区：[1]江苏省肿瘤医院放射科,江苏南京210009 [2]江苏省肿瘤医院乳腺外科,江苏南京210009

出　　处：《影像诊断与介入放射学》2015年第4期317-321,共5页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金项目(编号:81272470)

摘　　要：目的 探讨MRI引导下定位及活检对隐匿性乳腺癌的诊治价值。方法 回顾性分析以腋窝淋巴结肿大为首发症状,仅MRI发现为可疑乳腺癌患者21例;并采用1.5T超导MRI仪扫描,通过乳腺MRI专用定位活检仪,对这些仅MRI发现的乳腺癌病灶行MRI引导活检或行MRI导丝定位引导病灶切除活检,病理学证实这些可疑病灶就是隐匿性乳腺癌原发灶。结果 MRI检测到的21例可疑病灶。病变大小4-15mm。13个病灶呈肿块样强化,病灶强化形态：呈不规则形8个,分叶形5个;病灶强化边缘：呈毛刺状4个,不规则形9个;病灶内部强化特征：8个表现为环形强化,5个表现为不均匀强化。8个病灶呈非肿块样强化。强化病灶分布：2个呈局灶强化,2个呈线样强化,4个呈导管样强化;病灶内部强化特征：全部呈不均匀混杂样强化。18例行MRI引导导丝定位病灶切除并活检,3例行MRI引导病灶穿刺活检。病理浸润型导管癌。确诊后3例行术前新辅助化疗。13例行乳腺改良根治术,8例行MRI引导导丝定位病灶切除保乳手术。结论 通过MRI引导对隐匿性病灶行精准定位或活检,能够使部分保乳手术替代乳房切除术。Objective To explore the value of MRI-guided breast localization and biopsy in occult breast cancer. Methods 21 patients with axillary lymphadenopathy and suspicious lesions on MRI that were non-palpable and not visible on mammography or ultrasound underwent MRI-guided core biopsy （3）or hook wire localization before surgical resection （18）. All lesions were histologically confirmed to be invasive ductal carcinomas. Results The lesion size was 4-15mm and presented as mass-like enhancement （13） or non-mass-like enhancement （8） with ring （8）, heterogeneous （2）, focal （2）, linear （2） or ducal （4） enhancement. Of the 13 mass-like enhancement, 5 were lobulated and 8 were irregular in shape; 4 were spiculated and 9 had irregular margins. 3 patients received preoperative neoadjuvant chemotherapy. The patients underwent radical mastectomy （13） or local resection （8）. Conclusion MRI-guided breast localization and biopsy is helpful for detection and management of occult breast cancer.

关 键 词：乳腺肿瘤 隐匿性乳腺癌 腋窝淋巴结转移 磁共振成像 活组织检查 

分 类 号：R737.9[医药卫生—肿瘤]