乳腺导管内癌MRI动态增强特征与病理分级的相关性分析  

Correlation between dynamic contrast-enhanced MRI features and pathological grade of breast ductal carcinoma-in-situ

作　　者：周健[1] 张曦[2] 何妮[1] 李姣 伍尧泮[1] 许达生[3] ZHOU Jian;ZHANG Xi;HE Ni;LI Jiao;WU Yao-pan;XU Da-sheng(Department of Radiology,Sun Yat-sen University Cancer Center,Guangdong 510060,China)

机构地区：[1]中山大学肿瘤防治中心影像科,广东广州510060 [2]新疆医科大学附属肿瘤医院放射科,新疆乌鲁木齐830011 [3]中山大学附属第一医院放射科,广东广州510080

出　　处：《影像诊断与介入放射学》2020年第6期415-420,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的分析乳腺DCIS的MRI动态增强特征,并进一步分析其与病理分级的相关性。方法回顾性分析62例经大体标本术后病理证实为DCIS患者的临床影像资料,以病理结果为金标准,分析其MRI动态增强特征、强化模式及其与组织学核级别的相关性。结果术后病理证实低核级别DCIS 4例,中核级别DCIS 15例,高核级别DCIS 19例,DCIS伴浸润性癌24例。本研究将单纯性中、低核级别DCIS定义为非高核级别组。非高核级别DCIS组、高核级别DCIS组“非抱团样”及“抱团样”线样分支状强化均与DCIS伴浸润性癌组有统计学差异(P<0.05),非高核级别DCIS组与高核级别DCIS组无统计学差异(P>0.05)。非高核级别DCIS组、高核级别DCIS组Ⅰ型曲线出现频率明显大于DCIS伴浸润性癌组(P<0.05),Ⅱ、Ⅲ型曲线各组间均无统计学意义(P>0.05)。非高核级别DCIS组脉管内癌栓发生率显著低于DCIS伴浸润性癌组(P<0.05)。各组间免疫组化ER、PR、HER-2及Ki-67%表达均无统计学意义(P>0.05)。结论乳腺DCIS的MRI动态增强特征具有相对特异性,可提示病理核分级,可在一定程度上预测DCIS是否伴浸润性癌。Objective To correlate the dynamic enhanced MRI features of breast ductal carcinoma-in-situ(DCIS)with pathological grade.Methods The MRI of 62 women with pathologically confirmed DCIS was retrospectively analyzed.The dynamic enhancement features were correlated with histological nuclear grade.Results There were 4 low,15 middle,and 19 high nuclear grades of DCIS as well as 24 DCIS with invasive carcinoma.The non-agglomerating and agglomerating linear branching enhancement in DCIS with invasive carcinoma was significantly different from that of non-high(low and medium)or high nuclear grade DCIS(P<0.05).There was no significant difference in the enhancement pattern between non-high and high nuclear grade DCIS(P>0.05).The frequency of typeⅠdynamic enhancement curve was significantly higher in non-high and high nuclear grade DCIS than that in DCIS with invasive carcinoma(P<0.05)whereas the difference in typeⅡandⅢcurves was not significant among the groups(P>0.05).The incidence of intravascular tumor thrombus was significantly lower in non-high nuclear grade DCIS than that in DCIS with invasive carcinoma(P<0.05).There was no significant difference in the expression of ER,PR,HER-2 and Ki-67%in each group(P>0.05).Conclusion The dynamic contrast-enhanced MRI features of breast DCIS correlate with the pathological nuclear grade and may predict any associated invasive carcinoma.

关 键 词：乳腺 导管内癌 磁共振成像 动态增强 

分 类 号：R737.9[医药卫生—肿瘤]