乳腺导管原位癌的磁共振特征与病理对照关系  

Comparison between magnetic resonance and pathology in ductal carcinoma in situ patients

作　　者：张惠锋[1] 杨慧芬[2] 杜芳[1] 郝亮[1] 

机构地区：[1]杭州市中医院放射科,浙江杭州310007 [2]杭州市中医院乳腺外科,浙江杭州310007

出　　处：《中国现代医生》2016年第6期84-87,F0003,共5页China Modern Doctor

基　　金：浙江省中医药科学研究基金项目(2014ZB098)

摘　　要：目的探讨非肿块的乳腺导管原位癌（DCIS）的MRI表现与病理分级之间的相关性。方法回顾性分析我院2012年9月~2015年9月经手术病理证实的DCIS 67例患者并与MRI影像表现进行对照分析。结果在67例DCIS病例中,乳腺导管原位癌的非肿块样强化以线样（34.3%）和局灶（26.8%）强化为主,两组的病理Van Nuys分级以Ⅲ级为主,各占26.8%和17.9%。组内差异有统计学意义。内部强化特征以混杂（38.8%）和均匀（31.3%）强化为主,两者病理分级分别以Ⅲ级（31.3%）和Ⅱ级（14.9%）为主,组内差异有统计学意义。曲线类型以平台型21（31.3%）和廓清型（58.2%）为主,病理分级廓清型以Ⅲ级（58.2%）为主,差异有统计学意义。结论非肿块样DCIS MRI的形态、强化特征和曲线类型与病理分级有密切相关性。Objective To evaluate the correlation between characteristics of Magnetic Resonance Imaging（MRI） and pathological classification, ductal carcinoma in situ（DCIS） patients were observed. Methods Sixty seven DCIS patients verified by surgery pathology from September, 2012 to September, 2015 were retrospectively analysed, and were compared to characteristics of MRI image. Results In 67 cases, non-masslike enhancement lesions were observed mainly.34.3% of linear ductal enhancement and 26.8% focal enhancement occupied among the non-masslike enhancement lesions, respectively. And the corresponding rate of pathological Van Nuys classification was 26.8% and 17.9% respectively. Intra group statistical significance was approached. 38.8% of mixed reinforcement and 31.3% of homogeneous enhancement occupied in internal schedule of reinforcement. The Ⅲ pathology grade occupied 31.3% and Ⅱ grade accounted for 14.9%. Intra group statistical significance was approached in Ⅲ pathology grade, meanwhile,no significance was found in Ⅱ pathology grade. Platform 21 type（31.3%） and dissection（58.2%） type mainly showed in the dynamic enhancement curves, with Ⅲ pathology grade（58.2%） majorly found among dissection type. Statistical significance was approached. Conclusion Closely correlation between characteristics of Magnetic Resonance Imaging（MRI）and pathological classification was approached in ductal carcinoma in situ（DCIS） patients, in non-masslike enhancement lesions, internal schedule of reinforcement.

关 键 词：乳腺导管原位癌 磁共振成像 BI-RADS 病理分级 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]