乳腺导管内乳头状癌乳腺钼靶X线及MRI表现分析  

Intraductal papillary carcinoma of the breast:Analysis of mammography and MRI manifestations

作　　者：袁园[1] 李香营[1] 陈建强[1] 李海珍 梁其洲[1] 符水喜 YUAN Yuan;LI Xiang-yin;CHEN Jian-qiang;LI Hai-zhen;LIANG Qi-zhou;FU Shui-xi(Haikou Hospital Affiliated to Xiangya Medical College of Central South University/Haikou People's Hospital Department of Radiology,Haikou 570208)

机构地区：[1]中南大学湘雅医学院附属海口医院/海口市人民医院放射科,海南海口570208

出　　处：《海南医学院学报》2020年第24期1877-1881,共5页Journal of Hainan Medical University

基　　金：海南省重点研发计划项目(ZDYF2018175)。

摘　　要：目的:探讨乳腺钼靶X线及MRI在乳腺导管内乳头状癌(IDPC)中的诊断价值表现并比较两种方法的诊断价值。方法:收集2011年3月~2019年6月接受钼靶X线和MRI检查且经手术病理证实的28例IDPC患者,分析其影像表现,并比较两种方法对IDPC诊断准确率。结果:乳腺钼靶X线摄影:24例病灶呈肿块状,3例病灶呈不对称致密影伴钙化,1例病灶呈乳晕区大导管扩张,其中6例肿块的边缘可以看到短的毛刺。MRI扫描:28例病灶实性部分T1WI低信号,T2WI高信号。19例病灶呈囊实性肿块,囊壁见小结节,25例出现明显不均匀强化病灶。MRI的诊断准确率为89.3%(25/28),钼靶X线检查准确率75.0%(21/28),两种方法诊断准确率比较,差异无统计学意义(P=0.29)。两种检查方法联合使用,诊断准确率为96.4%,联合两种方法较单纯依靠钼靶X线诊断价值高(P=0.03)。结论:IDPC以小叶状或圆形肿块为特征,大囊肿合并小结节的管壁可能是这种癌症的一种特殊的MRI表现,联合乳腺钼靶X线及MRI可进一步提高IDPC的诊断水平。Objective To explore the diagnostic value of mammography and MRI in breast intraductal papillary carcinoma(IDPC)and compare the diagnostic value of the two methods.Methods Collected 28 IDPC patients who underwent mammography and MRI from March 2011 to June 2019 and were confirmed by surgery and pathology.The imaging manifestations were analyzed and the accuracy of IDPC diagnosis was compared between the two methods.Results Mammography of mammography 24 cases showed masses,3 cases showed asymmetric dense shadow with calcification,1 case showed large duct dilation in the areola area,and 6 cases showed short burrs on the edge of the tumor.MRI scan 28 cases of lesions had low signal intensity on T1WI and high signal on T2WI.19 cases showed cystic solid masses with small nodules on the cyst wall.25 cases showed obvious uneven enhancement lesions.The diagnostic accuracy of MRI was 89.3%.(25/28),the accuracy rate of mammography X-ray examination was 75.0%(21/28).There was no statistical difference in the diagnostic accuracy between the two methods,and it was not statistically significant(P=0.29).The combined use of the two inspection methods has a diagnostic accuracy rate of 96.4%.The combined two methods are more valuable than relying solely on mammography(P=0.03).Conclusion IDPC is characterized by lobular or round masses.Large cysts with small nodules may be a special MRI manifestation of this cancer.Combining mammography and MRI can further improve the diagnosis of IDPC.

关 键 词：乳腺癌 导管内乳头状癌 乳腺钼靶X光检查 核磁共振成像 

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