乳腺单纯型浸润性筛状癌影像特征及与叶状瘤的鉴别诊断  

The radiologic features of pure invasive cribriform carcinoma of breast and its differential diagnosis with phyllodes tumors

作　　者：双萍 盛复庚 周娟 张洪涛 SHUANG Ping;SHENG Fu-geng;ZHOU Juan;ZHANG Hong-tao(Department of Radiology,the Fifth Medical Center of Chinese PLA General Hospital,Beijing 100071,China)

机构地区：[1]解放军总医院第五医学中心放射诊断科,北京100071

出　　处：《中国临床医学影像杂志》2023年第10期705-709,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:分析乳腺单纯型浸润性筛状癌(ICC)MRI及超声影像表现,并与叶状瘤(PTs)鉴别,提高乳腺单纯型ICC的诊断水平。方法:收集解放军总医院第五医学中心经手术病理证实的乳腺单纯型ICC 10例、PTs 39例,回顾性分析乳腺单纯型ICC MRI及超声影像表现,并比较单纯型ICC与PTs的不同点。结果:单纯型ICC多表现为边界清楚的分叶状肿块、信号/回声均匀,MRI动态增强扫描延迟期病灶可见中心瘢痕样强化、边缘假包膜强化;PTs多数表现为分叶状肿块,信号/回声大多数不均匀;二者在形态学及超声表现上无统计学差异(P>0.05),在MRI内部信号及强化特征、TIC曲线及ADC值有统计学差异(P<0.05)。单纯型ICC超声诊断假阴性率70%,灵敏度30%,诊断准确率30%,MRI检查灵敏度100%,诊断准确率100%。结论:乳腺ICC是极少见的特殊类型乳腺癌,具有特殊的影像表现,与PTs的影像表现有部分重叠,MRI对乳腺ICC诊断的灵敏度、准确率均高于超声,有助于其与PTs的鉴别诊断。Objective:To analyze MRI and ultrasound imaging features of pure invasive cribriform carcinoma(ICC)of breast,and to explore the differences between phyllodes tumors(PTs),in order to improve the diagnostic of ICC of breast.Methods:Ten cases of pure ICC of breast and 39 cases of PTs confirmed by surgical pathology in the Fifth Medical Center of Chinese People’s Liberation Army General Hospital were collected,and their MRI and ultrasound imaging features were retrospectively analyzed and compared.Results:The pure ICC mostly showed as lobulated masses with circumscribed margins and homogeneous signal/echo,and the central scar-like enhancement and edge pseudocapsule enhancement were always observed in the delay phase of dynamic contrast-enhanced MRI.Most PTs showed lobulated masses with heterogeneous signal/echo.There was no significant difference in morphology and ultrasound features between the two groups(P>0.05),but there were significant differences in MRI signal and enhancement characteristics,TIC curve and ADC value(P<0.05).For the diagnosis of pure ICC,the false negative rate,sensitivity and diagnostic accuracy of ultrasound were 70%,30%and 30%,respectively,and the sensitivity and diagnostic accuracy of MRI were 100%and 100%,respectively.Conclusion:ICC of breast is a special type of breast cancer rarely seen.Pure ICC has particular imaging features,which partially overlap with the features of PTs.The sensitivity and diagnostic accuracy of MRI are higher than those of ultrasound,which is helpful for the differential diagnosis between ICC and PTs.

关 键 词：乳腺肿瘤 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]