摘要
目的应用磁共振分析乳腺良恶性肿瘤的MRI表现和增强动力学特征。方法 114例正常体检和怀疑乳腺病变者分别行1.5TMRI和(或)CR钼靶检查,其中65例患者在MRI检查后一月内行活检或手术治疗,得到117个有相应病理结果的乳腺肿块。观察分析良恶性病灶的形态学及动态造影剂强化MRI特征,并与肿瘤的组织病理学特征相关。结果 (1)良恶性肿瘤的诸项形态学特征相差非常显著(P<0.01),29例浸润性导管癌中,9例在MRI增强早期呈环形强化;(2)浸润性乳腺癌的第一分钟强化率>75%,而良性肿瘤的第一分钟强化率<50%,二者相差显著(P<0.05);(3)浸润性乳腺癌总体呈流出型强化曲线倾向,而良性肿瘤和良性病变总体呈线型强化曲线倾向,二者相差显著(P<0.05)。结论 (1)MRI可显示乳腺正常解剖和异常病变的形态学特征、增强动力学特征,对乳腺良恶性病变的诊断和鉴别诊断具有重要的价值;(2)MRI是目前检出和诊断浸润性导管癌最敏感的方法,增强早期环形强化是浸润性导管癌的特征性表现;(3)MRI对病变内的微钙化显示及诊断欠佳,须与乳腺钼靶等检查和临床病史相结合。
Objective To explore the characteristics of benign and malignant breast tumors before and after dynamic contrast-enhanced MRI images.Methods Total 114 cases of patients were examined by MRI and（or） CR mammography.117 breast masses of all patients were obtained with the histopathological results.The correlation between MRI findings and histological features in breast tumors were investigated.Results The morphologic features of benign and malignant breast tumors were obviously different.The enhancement rate（first post-contrast minute） was more than 75% in invasive breast cancers,which less than 50% in benign ones（P0.05）.Peripheral rim enhancement was found in 9 cases of invasive breast cancers.Type-Ⅰ time course was indicative of a benign lesion,whereas a type-Ⅲ（wash-out） time course strongly supported the diagnosis of a malignant lesion（P0.05）.Conclusion The features of morphologic and enhancement kinetics of breast and its lesions can be shown correctly on MRI.MRI is the most sensitive modality presently available for detection and staging to invasive breast cancer.Early rim enhancement of breast lesions at MRI imaging is distinctive in infiltrating ductal carcinoma（IDC）.As both the sensitivity and the specificity are lower in the microcalcified breast cancer,the diagnosis of MRI should combine with mammography and clinic history.
出处
《上海医学影像》
2010年第2期110-114,共5页
Shanghai Medical Imaging
基金
上海市闸北区中心医院789人才学科攀登计划基金
关键词
乳腺肿瘤
磁共振成像
动态增强
组织病理
Breast tumor
MRI Imaging
Dynamic contrast-enhancement
Histopathology
