中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (6): 463-468.doi: 10.3969/j.issn.1007-3969.2014.06.011

• 论著 • 上一篇    下一篇

MRI鉴别乳腺导管原位癌与其他导管内病变的价值

尤超,顾雅佳,彭卫军,毛健,姜婷婷   

  1. 复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2014-06-30 发布日期:2014-07-29
  • 通信作者: 彭卫军 E-mail:cjr.pengweijun@vip.163.com

MRI in the differential diagnosis of breast ductal cancer in situ

YOU Chao, GU Ya-jia, PENG Weijun, MAO Jian, JIANG Ting-ting   

  1. Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2014-06-30 Online:2014-07-29
  • Contact: PENG Wei-jun E-mail: cjr.pengweijun@vip.163.com

摘要:

背景与目的:乳腺导管原位癌(ductal carcinoma in situDCIS)属于乳腺浸润性癌的前驱病变,是一类非全身性的导管内局部病变,与其他导管内病变在影像上存在相似之处。本研究旨在探讨乳腺MRI鉴别诊断DCIS与其他乳腺导管内病变的价值。方法:回顾性分析20117月—20122月于复旦大学附属肿瘤医院行乳腺MRI检查并经手术病理证实的DCIS患者24例、DCIS伴微浸润(breast ductal carcinoma in situ with microinvasionDCIS-MI)9例、乳腺导管内乳头状瘤(breast intraductal papillomaBIDP)20例临床资料。以DCIS为研究主体,分析3种病变MRI及动态增强表现。结果:DCISDCIS-MI的病灶强化形态、强化方式、时间-信号强度曲线(TIC)、病灶伪彩图像间差异均无统计学意义(P0.05),而DCISBIDP的病灶强化形态、强化方式、TIC、病灶伪彩图像间差异均有统计学意义(P0.05)DCIS以导管样(8/24)及段样强化(6/24)为主、病灶伪彩图像为红色(22/24)TIC以Ⅲ型(12/24)为主要特征性表现;BIDP以乳头后局灶性强化为主(13/20)、病灶伪彩图像为非红色(14/20)TIC以Ⅱ型(11/20)为主要特征性表现。结论:MRI较难鉴别DCISDCIS-MI,但具有鉴别诊断DCISBIDP的价值。

关键词: 乳腺, 导管原位癌, 磁共振成像, 诊断

Abstract:

Background and purpose: Ductal carcinoma in situ (DCIS), is precursor lesions of invasive breast cancer, belongs to non-systemic ductal lesions, which is similar to other ductal lesions on imaging. This study aimed to investigate the differential diagnostic value of MRI in DCIS between DCIS with microinvasion (DCIS-MI) and breast intraductal papilloma (BIDP). Methods: All the cases were surgico-pathologically confirmed. Twenty-four patients were DCIS, 9 patients were DCIS-MI, and 20 patients were BIDP. The MRI charateristics of DCIS, DCIS-MI and BIDP were analyzed and compared. Results: DCIS and DCIS-MI’s performance in the form of MRI is difficult to differentiate (P<0.05). Compared with BIDP, the ductal and segmental enhancement, type time-signal intensity curve (TIC), and the red pseudo-color image were associated with the DCIS. The local area enhancement, type TIC, and no-red pseudo-color image were associated with BIDP. Conclusion: MRI is a useful for differentiate between DCIS and BIDP, but is difficult for DCIS and DCIS-MI.

Key words: Breast, Ductal carcinoma in situ, MRI, Diagnosis