表现为非肿块强化的乳腺小叶癌与导管癌MRI表征及病理相关指标对比分析  

Comparative Analysis of MRI Features and Pathological Related Indexes of Breast Lobular Carcinoma and Ductal Carcinoma with Non⁃Mass Enhancement

作　　者：谢福才 于海童 李芹[2] 黄川胜 陈永升 牛庆亮[2] XIE Fucai;YU Haitong;LI Qin(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan,Shandong Province 250355,P.R.China)

机构地区：[1]山东中医药大学第一临床医学院,济南250355 [2]潍坊市中医院医学影像中心,261031 [3]潍坊医学院医学影像学院,261053

出　　处：《临床放射学杂志》2024年第8期1298-1303,共6页Journal of Clinical Radiology

基　　金：山东省自然科学基金项目(编号:ZR202103060229)。

摘　　要：目的探讨动态对比增强磁共振成像(DCE⁃MRI)表现为非肿块强化(NME)的乳腺小叶癌与导管癌MRI表征的差异性,并对比分析病理相关指标。方法回顾性分析92例MRI表现为NME的乳腺癌患者的MRI特征及临床病理资料。根据病理结果将患者分为小叶癌组(41例)和导管癌组(51例)。分别采用χ^(2)检验或Fisher精确检验及Mann⁃Whitney U检验对比分析两组乳腺癌患者的MRI及临床病理资料,包括患者年龄、病变位置、病灶最大横径、乳腺腺体类型、是否多灶、瘤周水肿、NME分布及内部强化特征以及雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体⁃2(HER⁃2)状态、Ki⁃67指数、淋巴结转移等。结果乳腺小叶癌与导管癌在病灶最大横径(P=0.010)、多灶间强化带(P=0.038)、NME分布特征(P=0.042)、NME内部强化特征(P<0.001)、PR(P=0.047)、HER⁃2(P=0.004)、Ki⁃67指数(P=0.011)、淋巴结转移情况(P=0.033)差异有统计学意义(P<0.05);两组患者的病变位置(P=0.363)、腺体类型(P=0.293)、是否多灶(P=0.798)、瘤周水肿(P=0.518)和ER(P=0.162)差异无统计学意义(P>0.05)。结论表现为NME的乳腺小叶癌与导管癌患者的MRI表征及病理相关指标存在一定差异,这些特征有助于二者的MRI诊断及鉴别诊断。Objective To explore the differences in MRI features between breast lobular carcinoma and ductal carcinoma with non⁃mass enhancement(NME)on dynamic contrast⁃enhanced MRI(DCE⁃MRI),and to compare and analyze path⁃ological related indexes.Methods Imaging and pathological data of 92 breast cancer patients presenting with NME on MRI were retrospectively analyzed.They were divided into two groups according to the pathological results,including 41 cases of lobular carcinoma and 51 cases of ductal carcinoma.Chi⁃Squared or Fisher exact test and Mann⁃Whitney U test were used to compare and analyze the imaging and pathological data of the two groups of patients,including age,location and size of lesions,type of mammary gland,multifoci,peritumoral edema,distribution and internal enhancement features of NME,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor⁃2(HER⁃2)status,lymph node metastasis,etc.Results lobular carcinoma and ductal carcinoma showed statistical differences in the maximum transverse diameter(P=0.010),enhancing strands(P=0.038),NME morphological distribution(P=0.042),NME enhancement features(P<0.001),PR(P=0.047),HER⁃2(P=0.004),Ki⁃67(P=0.011)and lymph node metastasis(P=0.033).There were no significant differences in lesion location(P=0.363),gland type(P=0.293),multifoci(P=0.798),peritumoral edema(P=0.518)and ER(P=0.162)between the two groups(P>0.05).Conclusion There are certain differences in MRI features and pathological related indicators between breast lobular carcinoma and ductal carcinoma with NME.MRI can provide assistance for the pre⁃treatment diagnosis of lobular carcinoma and ductal carcinoma with NME.

关 键 词：乳腺癌 磁共振成像 非肿块强化 病理特征 乳腺小叶癌 

分 类 号：R737.9[医药卫生—肿瘤]