MRI对导管内乳头状瘤与浸润性导管癌的鉴别诊断价值  

The value of MRI in the differential diagnosis of intraductal papilloma and invasive ductal carcinoma

作　　者：孙诗昀 丁莹莹[1] 谢瑜[1] 吴建萍[1] 杨浩澜 李卓琳[1] SUN Shiyun;DING Yingying;XIE Yu;WU Jianping;YANG Haolan;LI Zhuolin(Department of Radiology,Yunnan Cancer Hospital,the Third Affiliated Hospital of Kunming Medical Universily,Kunming 650118,China)

机构地区：[1]昆明医科大学第三附属医院云南省肿瘤医院放射科,云南昆明650118

出　　处：《实用放射学杂志》2019年第11期1763-1767,共5页Journal of Practical Radiology

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项资金项目[2018FE001(-066)]。

摘　　要：目的探讨不规则肿块型导管内乳头状瘤(IDP)和浸润性导管癌(IDC)的MRI影像表现和特征,提高MRI对于二者的诊断准确率.方法回顾性纳入经手术病理证实为IDP和IDC的患者各33例,分析包括病灶大小、边界、内部成分、平扫信号强度、强化方式、ADC值及TIC在内的MRI表现.进行χ^2检验、t检验、秩和检验.结果2组相比,病灶边界(P<0.001)、大小(P<0.001)、ADC值(P<0.001)、强化方式(P=0.001)、TIC达峰时间(P<0.001)、斜率(P<0.001)和峰值强化率(P<0.001)有统计学差异(P<0.05);病变部位(P=0.159)、内部成分(P=0.778)、T2WI信号(P=0.438)、曲线类型(P=0.406)无统计学差异.结论不规则肿块型IDP与IDC具有相似的MRI表现,病灶边缘、ADC值、强化方式以及曲线达峰时间、斜率和峰值强化率对于二者的鉴别具有重要意义.Objective To investigate the MRI features and characteristics of irregular intraductal papilloma(IDP)and invasive ductal carcinoma(IDC),and to improve the diagnostic accuracy of MRI.Methods This study retrospectively included 33 patients with IDP and IDC confirmed by surgery and pathology,and analyzed MRI findings including lesion size,boundary,internal components,plain signal intensity,enhancement mode,ADC value and TIC curveχ^2 test,t test and rank-sum test were performed.Results Compared with the two groups,lesion boundary(P<0.001),size(P<0.001),ADC value(P<0.001),enhancement mode(P=0.001),TIC curve peak time(P<0.001),slope(P<0.001)and peak enhancement rate(P<0.001)were statistically significant(P<0.05);lesion(P=0.159),internal components(P=0.778),T2WI signal(P=0.438)and curve type(P=0.406)were no statistically difference.Conclusion The irregular mass type IDP and IDC have similar MRI findings,the edge of the lesion,the ADC value,the enhancement mode,and the peak time,slope and peak enhancement rate of the curve are important for the identification of the two diseases.

关 键 词：乳腺肿瘤 导管内乳头状瘤 浸润性导管癌 磁共振成像 

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