高场MRI对乳腺叶状肿瘤与乳腺纤维腺瘤鉴别诊断价值的研究  

Value of high field MRI in differential diagnosis of breast phyllodes tumor and breast fibroadenoma

作　　者：陈春兵[1] 黄清[1] 徐贵川[1] 莫荣广 蒋国元[1] 李仕广[1] CHEN Chunbing;HUANG Qing;XU Guichuan;MO Rongguang;JIANG Guoyuan;LI Shiguang(Department of Radiology,the First People's Hospital of Zunyi,Zunyi,Guizhou Province 563000,China)

机构地区：[1]遵义市第一人民医院放射科,贵州遵义563000

出　　处：《实用放射学杂志》2021年第10期1626-1630,共5页Journal of Practical Radiology

摘　　要：目的探讨高场MRI对乳腺叶状肿瘤及乳腺纤维腺瘤的鉴别诊断价值.方法回顾性分析经手术病理证实并行术前高场MRI检查的20例乳腺叶状肿瘤与81例乳腺纤维腺瘤患者,比较分析两者在高场MRI中肿瘤形态、大小、信号、表观扩散系数(ADC)值、强化方式、时间信号强度曲线(TIC)、波谱成像胆碱(Cho)峰值、血流动力学改变的差异.结果乳腺叶状肿瘤与乳腺纤维腺瘤组间肿瘤形态表现为多结节融合状、圆形或类圆形差异有统计学意义(P<0.05),而表现为分叶状、不规则形状差异无统计学意义(P>0.05);乳腺叶状肿瘤的最大横径明显高于乳腺纤维腺瘤(P<0.05);乳腺叶状肿瘤内T1WI高信号、T2WIG脂肪抑制(FS)信号不均匀、囊变、强化低信号分隔、瘤周晕征及瘤周曲张血管表现占比均明显高于乳腺纤维腺瘤(P<0.05);且两者肿瘤强化方式及TIC分型差异较大,有统计学意义(P<0.05);两者肿瘤ADC值、Cho峰值差异无统计学意义(P>0.05).结论乳腺叶状肿瘤与乳腺纤维腺瘤在高场MRI中肿瘤形态、大小、信号、强化方式及TIC、血流动力学改变存在一定差异;高场MRI检查对乳腺叶状肿瘤与乳腺纤维腺瘤有一定鉴别诊断价值,具有较高的临床应用价值.Objective To investigate the value of high field MRI in the differential diagnosis of breast phyllodes tumor and breast fibroadenoma.Methods 20 cases of breast phyllodes tumor and 81 cases of breast fibroadenoma confirmed by surgical pathology were analyzed retrospectively.All of the cases underwent high field MRI before surgery.The differences of tumor shape,size.signal,apparent diffusion coefficient(ADC)value,enhancement pattern,time-signal intensity curve(TIC),peak value of choline(Cho)and hemodynamic changes were compared between the two tumors.Results The morphologies of multi nodule fusion,round or oval were significantly different(P<0.05),but the morphologies of tabulated,irregular shape were no significantly different(P>0.05)between the phyllodes tumors and fibroadenomas.The maximum transverse diameter of the phyllodes tumors was significantly higher than that of the fibroadenomas(P<0.05);Hyperintensity in T_(1)WI,heterogeneity intensity and cystic change in T_(2)WI-fat suppression(FS),low signal separation in contrast-enhanced imaging,peritumoral halo sign and peritumoral varicose vessels were higher in the phyllodes tumors than in the fibroadenomas(P<0.05).There were significant differences in the tumor enhancement pattern and TIC classification between the two tumors(P<0.05).There were no significant differences in the ADC value and peak value of Cho between the two tumors(P>0.05).Conclusion There are significant differences in tumor shape,size,signal,enhancement pattern,TIC and hemodynamic changes between breast phyllodes tumor and breast fibroadenoma in high field MRI.High field MRI has certain differential diagnosis value for breast phyllodes tumor and breast fibroadenoma,and has high clinical application value.

关 键 词：乳腺 叶状肿瘤 纤维腺瘤 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]