MRI对乳腺叶状肿瘤与纤维腺瘤的鉴别价值  

The useful signs to differentiate breast phyllodes tumor from fibroadenoma using MRI

作　　者：史叶锋[1] 刘怡文[1] 谢文超[1] 朱玉娟[2] 

机构地区：[1]江苏大学附属宜兴医院放射科,江苏宜兴214200 [2]江苏大学附属宜兴医院病理科,江苏宜兴214200

出　　处：《医学影像学杂志》2015年第10期1797-1801,共5页Journal of Medical Imaging

摘　　要：目的对比乳腺叶状肿瘤(PT)与纤维腺瘤(FA)的MRI征象差异,探讨MRI对两者的鉴别价值。方法收集本院经手术病理证实的,有完整MRI资料的PT 21例(23个病灶)和FA35例(38个病灶),对其MRI征象进行统计学分析。结果 PT以边缘清楚的分叶状或多结节融合状多见(65.2%),少数可呈不规则形(8.7%);FA以圆形或类圆形多见(81.6%),无不规则形;T1WI上7个PT病灶见斑片状高信号(30.4%),病理提示出血或脂肪成分,FA均未见。T2WI抑脂PT多呈不均匀高信号(78.3%),FA多呈均匀高信号(86.8%);动态增强PT多呈明显不均匀强化(78.3%),可见低信号分隔(43.5%),囊变(39.1%)及瘤周曲张血管(21.7%);而FA多呈均匀强化(84.2%),可无强化或轻度强化(10.5%),可见低信号分隔(15.8%),瘤周无曲张血管;TIC曲线分型,PT以Ⅱ型多见(60.9%),FA以Ⅰ型多见(71.1%)。结论乳腺PT及FA各具一定特征性MRI征象,有助于两者的鉴别诊断。Objective To analyze the MRI signs of breast phytlodes tumors （PT） and fibroadenomas （FA） and to find differential diagnostic value between them. Methods The MR images of 21 patients with 23 PT proved by biopsy pathology were enrolled in this study. The results were compared with the MR images of 35 patients with 38 FA using fisher＇s exact test. Results PT showed as lobulated or multinodular fused shape with smooth edge commonly （65.2%）, irregular shape （8.7%）. FA showed as round or circular shape （81.6%）, no irregular shape occured. On non-enhanced T1WI, 7 cases of PT showed patchy hyperintense （bleeding or fat）, while this sign was not observed in FA. PT showed mixed high singals mostly （78.3%） on T2WI-FS, FA showed Homogeneous high signal （86.8%）. Most PT tended to be enhanced obviously and inhomogeneous （78.3 % ）, while FA showed homogeneous enhancement （84.2 % ）, mild enhancement or no enhancement （10.5%）. Only PT showed cystic lesions （39.1%） and twisted blood vessels around the tumor （21.7%）. Both tumors showed no-enhanced low signal lace. Type ]] TIC were observed in most PT（60.9%）, on the contrary Type I TIC were observed in most FA（71.1%）. Conclusion There are some useful signs between breast PT and FA, which they are helpful to differentiate them from each other.

关 键 词：乳腺肿瘤 叶状肿瘤 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]