乳腺癌根治术后上肢继发性淋巴水肿MR表现  

MR findings of secondary lymphedema in the upper-limb following mastectomy

作　　者：李滨[1] 王振常[1] 沈文彬[2] 常鲲[2] 刘洪亮 左利利 张捷 

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]首都医科大学附属北京世纪坛医院淋巴外科 [3]MR室

出　　处：《实用放射学杂志》2016年第11期1736-1739,共4页Journal of Practical Radiology

基　　金：北京学者（京人社专家发[2015]160号）;北京市医管局“使命”人才计划项目（SML20150101）.

摘　　要：目的初步探讨乳腺癌根治术后上肢继发性淋巴水肿的MR表现。方法回顾性分析本院收治的116例（其中3例为双乳切除，共119侧上肢）女性乳腺癌术后上肢继发性淋巴水肿病例，均行MR检查。结果根据临床Campisi分期，总结相应的MR表现。CampisiI期：患肢皮下软组织内MR表现均为细线征或细网格征。CampisiⅡ期：患肢皮下软组织内MR表现为网格征及平行带征（以浅部及中部分布为主），其中7例内可见条带征。CampisiⅢ期：患肢皮下软组织内MR表现为粗网格征及平行带征、条带征（以中部及深部分布为著），其中9例可见淋巴湖征。CampisiIV期：患肢皮下软组织内MR表现为淋巴湖征和深筋膜侧的条带征，其中2例内可见新月征。结论MR可以作为一种评价和诊断乳腺癌术后上肢继发性淋巴水肿的影像学方法。Objective To investigate initially the MR findings of secondary lymphedema （SLE） in the uppe^limb following mas- tectomy. Methods 119 sides of upper limbs within 116 cases of female patients with post-mastectomy in our hospital were analyzed retrospectively. MR were performed in all cases. Results Both the clinic Campisi stages and MR findings were comparatively ana- lyzed,MR findings in the subcutaneous soft tissue {SST} and beside the deep fascia（DF} were different. For Campisi stage I ,the fine-line sign distributing lonely in SST was showed on MR. For Campisi stage ]~ ,the grid sign and parallel-strip sign were distribu- ted dominantly in shallow and middle sections of SST, in which band signs on the DF were showed in 7 cases. For Campisi stage Ⅲ, the thick-grid sign, parallel-strip sign were distributed dominantly in middle and deep sections of SST, in which band signs on DF were showed in 9 cases. For Campisi stage IV,the thick-grid sign, parallel-strip sign and lymph-lake sign were distributed in SST, and band sign on DF,in which crescent sign under DF was showed in 2 cases. Conclusion MR can be a helpful tool for the evaluation and diagnosis of secondary lymphedema in the upper-limb following mastectomy.

关 键 词：乳腺癌根治术后 上肢 继发性 淋巴水肿 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R551.2[医药卫生—临床医学]