乳腺组织标记物对乳腺病灶磁共振评价的影响及临床意义  

Effect of breast tissue marker on MRI evaluation for breast lesions and clinical significance

作　　者：刘海晴 张汉臣 程子亮 曾伟科[1] 龚畅[2] 胡越[2] 吴卓[1] Liu Haiqing;Zhang Hanchen;Cheng Ziliang;Zeng Weike;Gong Chang;Hu Yue;Wu Zhuo(Department of Radiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120;Breast Tumor Center,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院放射科,广州510120 [2]中山大学孙逸仙纪念医院乳腺肿瘤中心,广州510120

出　　处：《中国医师杂志》2020年第3期337-341,346,共6页Journal of Chinese Physician

基　　金：国家重点研发计划(2017YFC1309100);国家自然科学基金(81671653)。

摘　　要：目的对比两种乳腺组织标记物的磁共振(MRI)表现,探讨不同乳腺组织标记物对MRI评价的影响和临床意义。方法回顾性分析2015年11月至2018年8月本院69例患者(共78个肿物)放置两种乳腺组织标记物的乳腺MRI。在横断位脂肪抑制T2WI、T1WI平扫及T1WI增强图像上评估乳腺组织标记物影的大小和形状。结果圈状无镍不锈钢合金标记物影的长径大于带状钛金属标记物的长径,在脂肪抑制T2WI序列中有统计学意义(P=0.039)。在T1WI增强图像中,所有圈状无镍不锈钢合金标记物影均>6 mm,带状钛金属标记物影20例>6 mm,8例≤6 mm;前者均为圆形,后者为圆形、点状和条状的分别有20例、7例、1例,两种乳腺组织标记物的大小及形状分类差异均具有统计学意义(P<0.001)。结论MRI不适于评价放置乳腺组织标记物体积较小的病变,带状钛金属标记物比圈状无镍不锈钢合金标记物产生的伪影范围小,对周围病变的干扰少,应根据临床需要选择合适的乳腺组织标记物和影像评估手段。Objective This study compares the magnetic resonance imaging(MRI)appearance of two types of breast tissue markers to investigate the appropriate clinical application of the markers.Methods Breast MRI of 69 patients(78 masses)with breast tissue markers had been placed were analyzed retrospectively from November 2015 to August 2018 in our hospital.The sizes and shapes of breast tissue markers were assessed in axial fat-suppressed T2-weighted images,T1-weighted images and contrast-enhanced T1-weighed images.Results The length of the coil nickel-free stainless steel markers were greater than ribbon titanium markers,with statistical difference in fat-suppressed T2-weighted images(P=0.039).In contrast-enhanced T1-weighted images,all coil nickel-free stainless steel markers showed>6 mm diameter and round shape,and ribbon titanium markers showed>6 mm diameter(n=20)or≤6 mm diameter(n=8),and round(n=20),dot(n=7)or band(n=1)shapes.The categories of sizes and shapes in two types of breast tissue markers both had statistical significance(P<0.001,P<0.001).Conclusions Small breast lesions with breast tissue markers are not suitable for MRI evaluation.The artifact of ribbon titanium markers is smaller than coil nickel-free stainless steel markers,so they have less impact for lesions.The choice of the breast tissue markers and image evaluation methods should depend on the different clinical conditions.

关 键 词：磁共振成像 乳腺肿瘤 定位标记 钛 不锈钢 

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