乳腺浸润性导管癌与不规则肿块型导管内乳头状瘤的MRI影像表现及特征比较  

Comparison of MRI Image Findings and Features of Breast Invasive Ductal Carcinoma and Irregular Mass Intraductal Papilloma

作　　者：李华梅 阳光辉[1] 张野 黄丽霞[1] LI Huamei;YANG Guanghui;ZHANG Ye;HUANG Lixia(Department of Interventional Radiology,Hunan Maternal and Child Health Hospital,Changsha 410008,China)

机构地区：[1]湖南省妇幼保健院介入放射科,长沙410008

出　　处：《医学综述》2021年第8期1651-1656,共6页Medical Recapitulate

摘　　要：目的比较乳腺浸润性导管癌与不规则肿块型导管内乳头状瘤的磁共振成像(MRI)影像表现及特征。方法选择2019年3月至2020年1月湖南省妇幼保健院收治的41例乳腺浸润性导管癌患者(导管癌组)与31例不规则肿块型导管内乳头状瘤患者(乳头状瘤组)的病历资料进行回顾性分析,术前均接受MRI检查,观察两组患者的MRI影像表现[T2加权成像(T2WI)信号、边界、内部成分、象限分布、表观弥散系数(ADC)值、病灶直径]、病灶内部强化特征、病灶时间-信号强度曲线(TIC)特征(TIC类型、最大增强斜率、达峰时间、峰值强化率)并进行比较。结果导管癌组病灶以毛刺样边界为主[65.85%(27/41)],乳头状瘤组病灶以边界清楚为主[54.84%(17/31)],差异有统计学意义(P<0.01);导管癌组的ADC值低于乳头状瘤组[(0.85±0.21)×10^(-3)mm^(2)/s比(1.14±0.26)×10^(-3)mm^(2)/s],导管癌组的病灶直径大于乳头状瘤组[(3.02±0.68)cm比(1.94±0.53)cm](P<0.01)。两组患者的病灶内部强化特征比较差异有统计学意义(P<0.05),其中导管癌组向心性强化患者的比例最高[43.90%(18/41)],乳头状瘤组小环形强化患者比例最高[64.52%(20/31)]。导管癌组最大增强斜率低于乳头状瘤组[(2.5±0.5)比(2.9±0.6)],达峰时间长于乳头状瘤组[(143.6±18.2)s比(122.6±16.1)s],峰值强化率高于乳头状瘤组[(209.7±25.4)%比(152.7±19.2)%](P<0.01)。结论乳腺浸润性导管癌与不规则肿块型导管内乳头状瘤的MRI影像表现具有一定相似性,但其病灶边界、ADC值、大小、内部强化特征及TIC最大增强斜率、达峰时间、峰值强化率存在明显差异,对两种疾病的诊断、鉴别有重要意义。Objective To investigate the magnetic resonance imaging(MRI)imaging findings and features of breast invasive ductal carcinoma and irregular mass intraductal papilloma.Methods A total of 41 patients with breast invasive ductal carcinoma(ductal carcinoma group)and 31 patients with irregular mass intraductal papilloma(papilloma group)who were admitted to the Hunan Maternal and Child Health Hospital from Mar.2019 to Jan.2020 were included,and their medical records were retrospectively analyzed.All the patients were examined by MRI before operation,and the lesions MRI imaging findings[T2-weighted imaging(T2 WI)signal,boundary,internal components,quadrant distribution,apparent diffusion coefficient(ADC)value,lesion diameter],the internal enhancement features,the time-signal intensity curve(TIC)features(TIC types,maximum enhancement slope,peak time,peak enhancement rate)of the two groups were observed and compared.Results The lesions in the ductal carcinoma group were mainly with burr-like boundary[65.85%(27/41)]and in the papilloma group were mainly with clear boundary[54.84%(17/31)],the difference was statistically significant(P<0.01);the ADC value of the ductal carcinoma group was lower than that of the papilloma group[(0.85±0.21)×10^(-3)mm^(2)/s vs(1.14±0.26)×10^(-3)mm^(2)/s],and the lesion diameter of the ductal carcinoma group was larger than that of the papilloma group[(3.02±0.68)cm vs(1.94±0.53)cm](P<0.01).There was significant difference in the internal enhancement features of lesions between the two groups(P<0.05):the proportion of patients with concentric enhancement in the ductal carcinoma group was the highest[43.90%(18/41)],and the proportion of patients with small ring enhancement in the papilloma group was the highest[64.52%(20/31)].The maximum enhancement slope of the ductal carcinoma group was lower than that of the papilloma group[(2.5±0.5)vs(2.9±0.6)],the peak time was longer than that of the papilloma group[(143.6±18.2)s vs(122.6±16.1)s],and the peak enhancement rate was higher than that o

关 键 词：乳腺肿瘤 浸润性导管癌 导管内乳头状瘤 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]