乳腺良恶性实性乳头状肿瘤的诊断与鉴别诊断  

The Diagnosis and Differential Diagnosis of Benign and Malignant Solid Papillary Neoplasms

作　　者：高红 席佳佳 瞿献莉 GAO Hong;XI Jia-jia;QU Xian-li(Department of Radiology,Eastern Theater Command General Hospital,Nanjing 210002,Jiangsu Province,China;Department of Imaging,Qinhuai Medical Area,Eastern Theater Command General Hospital,Nanjing 210002,Jiangsu Province,China)

机构地区：[1]东部战区总医院放射诊断科,江苏南京210002 [2]东部战区总医院秦淮医疗区影像科,江苏南京210002

出　　处：《中国CT和MRI杂志》2022年第7期84-87,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨磁共振(MRI)征象及表观扩散系数(ADC)值在乳腺实性乳头状癌与良性导管内乳头状瘤诊断中的应用价值。方法回顾性分析本院2014年1月至2020年10月收治的经穿刺或手术病理证实的26例乳腺实性乳头状癌(SPC)与52例良性导管内乳头状瘤(BIDP)患者临床资料,比较两组MRI征象及ADC值差异,分析MRI征象及ADC值联合对于疾病的鉴别评估价值。结果SPC患者结节/肿块病灶9例,非肿块样强化病灶17例;BIDP患者结节/肿块病灶40例,非肿块样强化病灶.12例。SPC患者结节/肿块病灶比例低于BIDP(P<.005);SPC患者结节/.肿块病灶边界不规则比例7778%.高于BIDP病灶1500%.,内部强化.特点均匀比例2222%低于BIDP病灶7500%(P<005);SPC患者.非肿块样强化病灶内.部强化特.点为集丛状比例6471%高于BI.DP病灶833%(P<005).;SPC患者.多发病灶比例6538%高于BIDP患者2500%(P<005.);SPC患者与BIDP患者病灶早期强化率比较(.P>005);SPC患者病灶ADC值低于BIDP患者(P<005);MRI征.象联合ADC值对SPC与BIDP鉴别.诊断准确度为9103%,高于单.独MRI征.象诊断7692%,高于单独ADC值诊断7436%(P<005)。结论乳腺SPC与BIDP病灶MRI征象存在差异,且SPC病灶ADC值低于BIDP,MRI征象联合ADC值可提高乳腺SPC和BIDP鉴别诊断准确度。Objective To explore the application value of magnetic resonance(MRI) signs and apparent diffusion coefficient(ADC) values in the diagnosis of solid papillary carcinoma(s PC) and benign breast intraductal papilloma(BIDP). Methods The clinical data of 26 s PC cases and 52 BIDP cases confirmed by puncture or surgical pathology who were admitted to the hospital from January 2014 to October 2020 were retrospectively analyzed. The differences in MRI signs and ADC values between the two groups were compared. The value of MRI signs combined with ADC values in the differential diagnosis of diseases was analyzed. Results In s PC patients, there were 9 cases with nodules/lumps and 17 cases with non-mass enhancement lesions. In BIDP patients, there were 40 cases with nodules/lumps and 12 cases with non-mass enhancement lesions. The proportion of cases with nodules/lumps in s PC patients was lower than that in BIDP patients(P<0.05), proportion of cases with irregular borders of nodules/lumps was higher than that in BIDP patients(77.78% vs.15.00%), proportion of cases with homogeneous internal enhancement was lower than that in BIDP patients(22.22% vs.75.00%)(P<0.05), proportion of cases with cluster internal enhancement was higher than that in BIDP patients(64.71% vs.8.33%)(P<0.05), and proportion of cases with multiple lesions was higher than that in BIDP patients(65.38% vs.25.00%)(P<0.05). The difference in early enhancement rate of lesions between s PC patients and BIDP patients was not statistically significant(P>0.05). ADC values of lesions in s PC patients were lower than those in BIDP patients(P<0.05). The accuracy of MRI signs combined with ADC values in the differential diagnosis of s PC and BIDP was 91.03%, greater than that of MRI signs and ADC values alone(76.92%, 74.36%)(P<0.05). Conclusion The MRI signs of s PC and BIDP are different. ADC value of s PC is lower than that of BIDP. The combination of MRI signs and ADC values can improve the accuracy in the differential diagnosis of sPC and BIDP.

关 键 词：乳腺实性乳头状癌 良性导管内乳头状瘤 磁共振成像 表观扩散系数 鉴别诊断 

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