乳腺叶状肿瘤与单纯型黏液癌的MRI征象及鉴别诊断  

MRI features and differential diagnosis of phyllodes tumor and pure mucinous breast carcinoma

作　　者：曲宁[1] 罗娅红[1] 李森[1] 

机构地区：[1]中国医科大学肿瘤医院、辽宁省肿瘤医院医学影像科,沈阳110042

出　　处：《放射学实践》2017年第2期139-143,共5页Radiologic Practice

摘　　要：目的:探讨乳腺叶状肿瘤(PT)和单纯型黏液癌(PMBC)的MRI表现和鉴别诊断。方法:回顾性分析经手术病理证实的16例PT和23例PMBC的临床及MRI资料,包括发病年龄、MRI征象、Fischer评分结合BI-RADS分类、早期增强率(EER),对两者的上述资料进行统计学分析。结果:PT的发病年龄比PMBC小(t=-2.189,P<0.05);PT和PMBC在T1及T2信号特征、内部强化特征、时间-信号强度曲线(TIC)类型上差异均具有统计学意义(P均<0.05);PT和PMBC在病灶大小、形态、边缘、低信号分隔、邻近血管征象(AVS)、Fischer评分结合BI-RADS分类上均无统计学差异(P均>0.05);PT的EER高于PMBC(P<0.05),EER鉴别诊断PT和PMBC的受试者操作特征(ROC)曲线下面积为0.750,最佳界值为136.25%,诊断试验的敏感度为68.8%,特异度为81.8%,诊断符合率为76.3%。结论:虽然PT和PMBC的MRI表现多有重叠,但结合多个征象进行综合分析有助于两者的鉴别诊断。Objective：To investigate MRI features and differential diagnosis of phyllodes tumor（PT）and pure mucinous breast carcinoma（PMBC）.Methods：The clinical data and MR findings of 16 patients with PT and 23 patients with PMBC confirmed by operation and pathology were analyzed retrospectively.The features included age,MRI findings,the Fischer score binding with BI-RADS classification and early enhancement rate（EER）,the above data were statistically analyzed.Results：The age of PT patients was younger than that of PMBC（P〈0.05）.There were significant differences in the signal features of T1 and T2,enhancement pattern and time-signal intensity curve（TIC）between the two groups（P〈0.05）.However,there were no significant statistical differences in the lesion size,shape,edge,internal dark signal separation,adjacent vascular signs（AVS）,Fischer score and BI-RADS classification between PT and PMBC.The values of EER of PT were higher than that of PMBC（P〈0.05）,area under ROC curve was 0.750,the optimal cut-off value was 136.25% with the sensitivity,specificity and accuracy as 68.8%,81.8%,76.3% respectively.Conclusion：MRI features of PT and PMBC may overlap,however,the comprehensive analysis combined with multiple characteristics is beneficial for the differential diagnosis.

关 键 词：乳腺肿瘤 叶状肿瘤 黏液癌 磁共振成像 诊断 鉴别 

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