乳腺浸润性微乳头状癌的MRI和乳腺X线摄影特征分析  

MRI and mammography characteristics of invasive micropapillary carcinoma of the breast

作　　者：陈佳儿 江森[1] 肖莹[1] 李仰康[1] CHEN Jia’er;JIANG Sen;XIAO Ying;LI Yangkang(Department of Radiology,Cancer Hospital of Shantou University Medical College,Shantou 515041,Guangdong,China)

机构地区：[1]汕头大学医学院附属肿瘤医院放射科,广东汕头515041

出　　处：《中国现代医生》2024年第13期43-46,共4页China Modern Doctor

摘　　要：目的探讨乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)在磁共振成像(magnetic resonance imaging,MRI)和乳腺X线摄影(mammography,MG)中的影像学特征。方法回顾性收集2017年1月至2023年4月于汕头大学医学院附属肿瘤医院经活检穿刺或手术病理证实的25例IMPC患者的临床资料,所有患者均行MRI检查,其中20例行MG检查,记录并分析患者的影像学特征、组织病理学特征及受体状态。结果25例患者中20例可触及肿物;MRI共检出33个病变,1例患者为非肿块病变,24例患者为肿块样病变。肿块形状以不规则为主,边缘多不规则或毛刺样,表观扩散系数为(0.862×10–3±0.135×10–3)mm2/s;肿块时间-信号强度曲线以平台或流出型为主。MG显示1例患者无异常,19例患者共检出22个病变,肿块形状多不规则,边缘不清或毛刺状,10例患者显示肿块伴有微钙化。乳腺MRI、MG检查分别检出11例、6例淋巴结异常,最终病理显示14例患者发生腋窝淋巴结转移。免疫组织化学结果显示,雌激素受体阳性24例、孕激素受体阳性22例、人类表皮生长因子受体2阳性7例。结论IMPC影像学上多表现为形态不规则、边界不清晰、边缘多毛刺、不均匀强化、软组织肿块伴微钙化,同时腋窝淋巴结转移率高,对IMPC的临床治疗及预后评价可提供重要参考。Objective To investigate the imaging features of invasive micropapillary carcinoma(IMPC)of the breast in magnetic resonance imaging(MRI)and mammography(MG).Methods The clinical data of 25 patients with IMPC confirmed by biopsy or surgical pathology were retrospectively collected from Cancer Hospital of Shantou University Medical College from January 2017 to April 2023.All patients underwent MRI examination,20 of which underwent MG examination.Imaging features,histopathological features and receptor status of patients were recorded and analyzed.Results In 25 patients,20 patients had palpable mass.A total of 33 lesions were detected by MRI.One patient had a non-mass lesion and 24 had a lump-like lesion.The lump was mainly irregular in shape,with irregular or burr edges,and the apparent diffusion coefficient was(0.862×10-3±0.135×10-3)mm2/s.The time-signal intensity curve of the lump was mainly flat or outflow type.MG showed no abnormality in one patient,22 lesions were detected in 19 patients,and the lump were mostly irregular in shape,with unclear edges or burrs,and 10 patients showed the lump accompanied by microcalcification.Lymph node abnormalities were detected in 11 cases by MRI and 6 cases by MG,respectively,and axillary lymph node metastasis was found in 14 cases by final pathology.Immunohistochemical results showed that 24 cases were positive for estrogen receptor,22 cases were positive for progesterone receptor and 7 cases were positive for human epidermal growth factor receptor 2.Conclusion The imaging findings of IMPC mostly showed irregular shape,unclear boundary,multiple burrs at the edge,uneven enhancement,soft tissue mass with microcalcification,and high axillary lymph node metastasis rate,which could provide important references for the clinical treatment and prognosis evaluation of IMPC.

关 键 词：浸润性微乳头状癌 磁共振成像 乳腺X线摄影 病理 

分 类 号：R445.2[医药卫生—影像医学与核医学]