磁共振成像及超声诊断乳腺导管内乳头状瘤的价值比较  

Comparision of magnetic resonance imaging and ultrasound in diagnosis of breast intraductal papilloma

作　　者：谢菲[1] 周波[1] 王殊[1] 曹迎明[1] 刘鹏[1] 袁飞[2] 

机构地区：[1]北京大学人民医院乳腺中心,100044 [2]北京大学人民医院医学影像科,100044

出　　处：《中国医药》2016年第2期271-274,共4页China Medicine

摘　　要：目的探讨磁共振成像（MRI）和超声对乳腺导管内乳头状瘤的诊断价值。方法回顾性分析2009年2月至2015年4月北京大学人民医院收治的74例导管内乳头状瘤患者的超声和MRI影像资料，比较二者病变检出率和诊断准确率。结果74例患者中超声可见肿物47例（63．5％），呈低回声34例（72．3％）、无回声7例（14．9％）、混合回声6例（12．8％）；圆形22例（46．8％）、分叶状9例（19．1％）、不规则形16例（34．0％）；边缘清楚29例（61．7％）、不清18例（38．3％）；后方回声增强23例（48．9％）、无改变24例（51．1％）。74例患者中MRI可见肿物60例（81．1％），呈圆形44例（73．3％）、分叶状7例（11．7％）、不规则型9例（15．0％）；边缘清楚44例（73．3％）、不规整9例（15．0％）、毛刺7例（11．7％）；肿物内部均匀强化53例（88．3％）、不均匀强化6例（10．0％）、边缘强化1例（1．7％）；时间-信号曲线呈Ⅰ型25例（41．7％）、Ⅱ型22例（36．7％）、Ⅲ型13例（21．7％）。MRI、MRI联合超声的病变检出率高于超声[93．2％（69／74）、100．0％（74／74）比66．2％（49／74）]（P〈0．001）；MRI和超声的诊断准确率差异无统计学意义[56．8％（42／74）比43．2％（32／74）]（P=0．100），二者联合诊断准确率为60．8％（45／74），高于超声（P=0．032）。结论MRI对导管内乳头状瘤病变检出率高于超声，诊断准确率二者相仿；二者联合应用病变检出率和诊断准确率均高于超声。Objective To compare the values of magnetic resonance imaging （MRI） and uhrasonographic （US） in diagnosis of breast intraductal papilloma （IP）. Methods The US and MRI data of 74 patients from February 2009 to April 2015 with IP were retrospectively analyzed. The detection rate and accuracy rate of US and MRI were compared. Results In 74 cases, the mass was observed in US in 47 cases; there were 34 （72. 3% ） of were hypoecho, 7 （ 14. 9% ） of anechoic and 6 （ 12. 8% ） of mixed echo; there were 22 （46. 8% ） of circular shape, 9 （19.1%） of lobulated shape and 16 （34.0%） of irregular shape; there were 29 （61.7%） with clear margin and 18 （38.3%） with unclear margin; there were 23 （48.9%） with posterior acoustic enhancement and 24 （51.10%） with no change. MRI found the mass in 60 cases; there were 44 （73.3%） of circular shape, 7 （ 11.7% ） of lobulated shape and 9 （ 15.0% ） of irregular shape; there were 44 （73.3%） with clear margin, 9 （ 15.0% ） with irregular margin and 7 （ 11.7% ） with spieulated margin; there were 53 （88.3%） with internal homogeneous enhancement, 6 （10. 0% ） with internal heterogeneous enhancement and 1 （1.7%） with edge enhancement; there were 25 （41.7%） of type Ⅰ time-signal intensity curve （TIC） , 22 （36. 7% ） of type Ⅱ TIC and 13 （21.7%） of type Ⅲ TIC. The detection rate of MRI and MRI combined with US was significantly higher than that of US [93.2% （69/74）, 100. 0% （74/74） vs 66. 2% （49/74） 1 （P 〈0. 001） ; the accuracy rate of MRI and US was not significantly different [56. 8% （42/74） and 43.2% （32/74） ] （P =0. 100）, the accuracy rate of MRI combined with US [ 60. 8 （ 45/74 ） l was significantly higher than that of US （ P = 0. 032 ）. Conclusion MRI has higher detection rate and similar accuracy rate compared with US in IP patients; detection rate and accuracy rate of MRI combined with US are both increased compared with single use of US.

关 键 词：导管内乳头状肿瘤 磁共振成像 超声 

分 类 号：R737.9[医药卫生—肿瘤]