摘要
目的 探讨乳腺叶状肿瘤(BPTs)MRI形态和功能表现,及其与病理对照分析结果,以提高乳腺叶状肿瘤的诊断水平。方法 回顾性分析13例BPTs患者的临床及MRI影像学资料,并与病理结果进行对照。结果 13例患者中,术前MRI诊断为BPTs8例,纤维腺瘤4例,脂肪肉瘤1例,准确率为61.5%(8/13)。BPTs的T1加权成像(T1WI)表现为较低信号,2例良性、4例交界性及2例恶性BPTs瘤体内有不规则小片状、裂隙状更低信号区,其余均表现为均匀信号;T2加权成像(T2WI)表现为较高信号,除2例良性BPTs信号均匀外,其余BPTs瘤体内可见线样分隔呈稍低信号,瘤体内T1WI所见不规则小片状、裂隙状更低信号区在T2WI表现为更高信号区。扩散加权成像(DWI)序列均表现为等或稍高信号,良性BPTs表观弥散系数(ADC)值为(1.33~2.59)×10^-3mm^2/s,交界性BPTsADC值为(1.21~2.83)×10^-3mm^2/s,恶性BPTsADC值为(0.81~2.41)×10^-3mm^2/s。2例良性、1例交界性BPTs的时间-信号曲线为Ⅰ型曲线,5例良性、2例交界性、1例恶性BPTs为Ⅱ型曲线,1例交界性、1例恶性BPTs部分为Ⅱ型、部分为Ⅲ型曲线。6例良性、2例交界性BPTs为边缘光滑型,其余为局部边缘不规则型。结论 MRI检查显示BPTs肿瘤边缘大部分光滑,仅交界性及恶性BPTs部分边缘不规则,T2WI脂肪抑制序列呈高信号,其内见分隔,增强扫描时间-信号曲线以平台型及上升型为主,DWI序列大多未见扩散受限。
Objective To investigate the morphological and functional features of breast phyllodes tumors(BPTs)on MRI and their comparison with pathological findings,so as to improve the diagnostic level of BPTs.Methods The clinical and MRI image data of 13 patients with BPTs were retrospectively analyzed and compared with pathological findings.Results Of the 13 cases,8 were diagnosed with BPTs on preoperative MRI,4 with fibroadenoma and 1 with liposarcoma,with an accuracy rate of 61.5%(8/13).On T 1-weighted imaging(T 1WI),BPTs were hypointense,2 benign,4 borderline,and 2 malignant BPTs cases appeared with irregular patchy and fissure-like hypointense areas inside,the remaining cases were characterized by hemogeneous signal;on T 2-weighted imaging(T 2WI),BPTs were hyperintense,except 2 benign BPTs cases with hemogeneous signal,the remaining BPTs cases were hypointense with streaky septations inside,those featured by irregular patchy and fissure-like hypointense areas inside on T 1WI presented hyperintense areas on T 2WI.All diffusion-weighted imaging(DWI)sequences displayed isointense or slightly hyperintense signal,apparent diffusion coefficient values of benign,borderline,and malignant BPTs were(1.33-2.59)×10^-3 mm^2/s,(1.21-2.83)×10^-3 mm^2/s and(0.81-2.41)×10^-3 mm^2/s,respectively.Two benign and 1 borderline BPTs cases reported typeⅠtime-signal intensity curve(TIC),5 benign,2 borderline,and 1 malignant BPTs cases reported typeⅡTIC,1 borderline and 1 malignant BPTs cases made their TIC appear partially of typeⅡand partially of typeⅢ.Six benign and 2 borderline BPTs cases were defined as smooth-margin type,the remaining cases as local-irregular-margin type.Conclusion MRI examination reveals that BPTs have smooth tumor margin mostly,only borderline and malignant BPTs exhibit irregular margin partially,T 2WI sequence presents high signal and internal septations for fat suppression,enhanced scan TICs appear mainly with plateau pattern and ascending pattern,and the majority of DWI sequences have no diffusion limitation.
作者
谢东
李强
康巍
唐琪
刘丽东
朱旭娜
赵欣
陈军
张卫
XIE Dong;LI Qiang;KANG Wei;TANG Qi;LIU Li-dong;ZHU Xu-na;ZHAO Xin;CHEN Jun;ZHANG Wei(Image Diagnosis Center,Guangxi Medical University Affiliated Tumor Hospital,Nanning 530021,China)
出处
《广西医学》
CAS
2019年第10期1219-1222,共4页
Guangxi Medical Journal
基金
广西医药卫生科研课题(Z2016476)
关键词
乳腺叶状肿瘤
良性
交界性
恶性
鉴别诊断
加权成像
表观弥散系数
磁共振成像
形态
病理
Breast phyllodes tumors
Benign
Borderline
Malignancy
Differential diagnosis
Weighted imaging
Apparent diffusion coefficient
Magnetic resonance imaging
Morphology
Pathology
