乳腺浸润性小叶癌的MRI表现及对比超声对多发病灶检出价值的研究

发布时间：2018-03-03 13:04

本文选题：乳腺肿瘤　切入点：磁共振成像　出处：《放射学实践》2015年11期 　论文类型：期刊论文

【摘要】：目的:分析乳腺浸润性小叶癌(ILC)的MRI表现,并与超声对照,对比两种方法对多发病灶的检出价值。方法:回顾性研究经手术病理证实的19例乳腺ILC的MRI及超声表现,并分析两种方法对多发病灶的检出情况。结果:19例乳腺ILC在MRI上表现为肿块强化15例,非肿块强化2例,两种强化类型均有的混合型1例,另有1例患者MRI结果阴性(B超、钼靶结果均为阴性)。15例肿块强化中,边缘毛刺状的不规则形肿块11例;2例非肿块强化中,局灶性、多区域性分布各1例;1例混合型表现为多区域性分布。18例阳性乳腺ILC动态增强后,TIC早期缓慢强化1例,中度强化3例,快速强化14例;延迟期上升型8例,平台型4例,流出型6例。18例行超声检查的浸润性小叶癌中,检出阳性者17例,其中12例ILC在超声上表现为不规则的不均匀低回声肿块。18例阳性乳腺ILC中,MRI诊断多灶及多中心均为4例且经病理证实,超声诊断单发4例、多灶3例、多中心1例,两种方法对病变多灶及多中心性的检出率差异具有统计学意义(P=0.026,P0.05)。2例同侧乳房其他病灶均经MRI、超声检出,1例对侧乳房其他病变仅通过MRI检出。结论:乳腺ILC的MRI表现具有一定特征性,且对多发病灶的检出较超声有一定优势。
[Abstract]:Objective: to analyze the MRI findings of invasive lobular carcinoma of the breast (ILC) and to compare the value of the two methods in the detection of multiple lesions. Methods: the MRI and ultrasound findings of 19 cases of breast ILC proved by operation and pathology were retrospectively studied. Results 19 cases of breast ILC showed mass enhancement in 15 cases, non-mass enhancement in 2 cases, mixed type of two types of enhancement in 1 case, and negative MRI results in 1 case (B ultrasound). The results of molybdenum target were all negative in 15 cases of mass enhancement, and 11 cases of irregular shape masses with brim spines in 2 cases of non-mass enhancement. In 1 case of multiple regional distribution and 1 case of mixed type, 18 cases of positive breast ILC showed slow enhancement in early stage, moderate enhancement in 3 cases, rapid enhancement in 14 cases, delayed ascending type in 8 cases and platform type in 4 cases. Of the 6 cases of efflux type. 18 cases of invasive lobular carcinoma examined by ultrasound, 17 cases were positive. Among them, 12 cases of ILC showed irregular and heterogeneous hypoechoic masses on ultrasound. Among 18 cases of positive breast ILC, 4 cases were diagnosed as multi-focus and multi-center, and 4 cases were confirmed by pathology. Ultrasound diagnosis included single lesions in 4 cases, multiple foci in 3 cases, and multicenter in 1 case. There were significant differences between the two methods in the detection rate of multi-foci and multicentric lesions. All the other lesions of ipsilateral breast were detected by MRI.The other lesions of the contralateral breast were detected only by MRI by ultrasonography. Conclusion: the MRI table of breast ILC is positive. Now it has some characteristics. And the detection of multiple lesions has a certain advantage over ultrasound.
【作者单位】：上海交通大学医学院附属新华医院放射;
【基金】：国家自然科学基金(81371621) 上海市卫生系统优秀学科带头人计划(XBR2013110)
【分类号】：R445.2;R737.9

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