不同病理类型乳腺化生性癌超声及MRI表现

目的 观察不同病理类型乳腺化生性癌（MCB）的超声及MRI表现。方法 回顾性分析22例经手术或穿刺活检病理证实的单发MCB患者，均接受乳腺超声检查，9例接受乳腺MRI；观察不同病理类型MCB超声及MRI表现。结果 22例中，鳞状细胞癌7例（7/22，31.82%），伴间叶分化的化生性癌7例（7/22，31.82%），未分类癌4例（4/22，18.18%），梭形细胞癌2例（2/22，9.09%），低级别腺鳞癌及肌上皮癌各1例（1/22，4.55%）。超声见鳞状细胞癌多呈形状不规则（6/7，85.71%）、边缘不完整（4/7，57.14%）的低回声（5/7，71.43%），纵横比<1（6/7，85.71%）；伴间叶分化的化生性癌多为不规则囊实混合回声团块（4/7，57.14%），边缘不完整（4/7，57.14%），后方回声增强（4/7，57.14%）；梭形细胞癌、低级别腺鳞癌、肌上皮癌及未分类癌多为不规则形（6/8，75.00%）、边缘完整（7/8，87.50%）的低回声肿块，后方回声各异。2例鳞状细胞癌、3例伴间叶分化的化生性癌、2例未分类癌、肌上皮癌和低级别腺鳞癌各1例接受MR检查，病灶均呈长T1、长T2信号，弥散加权成像呈高信号，增强后均匀或不均匀强化。结论 不同病理类型MCB超声及MRI表现各有一定特点。

Ultrasonic and MRI manifestations of different pathological types metaplastic carcinoma of breast

Objective To observe the ultrasonic and MRI manifestations of different pathological types metaplastic carcinoma of breast (MCB). Methods Data of 22 patients with MCB confirmed by pathologically were retrospectively analyzed. All patients underwent breast ultrasound, while 9 patients underwent breast MR examinations. The ultrasonic and MRI manifestations of different pathological types MCB were observed. Results Among 22 cases, there were 7 cases (7/22,31.82%) of squamous cell carcinoma, 7 cases (7/22,31.82%) of mesenchymal differentiated metaplastic carcinoma, 4 cases (4/22, 18.18%) of unclassified carcinoma, 2 cases (2/22, 9.09%) of spindle cell carcinoma, 1 case (1/22,4.55%) of low-grade adenosquamous carcinoma and 1 case (1/22,4.55%) of myoepithelial carcinoma. Ultrasonography showed that most squamous cell carcinoma were hypoechoic (5/7, 71.43%), with irregular shape (6/7, 85.71%), incomplete margin (4/7, 57.14%) and aspect ratio <1 (6/7, 85.71%). The most common findings of mesenchymal differentiated metaplastic carcinoma were irregular cystic and solid mixed echogenic mass (4/7, 57.14%) with incomplete margin (4/7, 57.14%) and posterior echogenic enhancement (4/7, 57.14%). Most spindle cell carcinoma, low-grade adenosquamous carcinoma, myoepithelial carcinoma and unclassified carcinoma present as irregular shape (6/8, 75.00%) and intact margin (7/8, 87.50%) hypoechoic mass, with different posterior echoes. Two cases of squamous cell carcinoma, 3 mesenchymal differentiated metaplastic carcinoma, 2 unclassified carcinoma, 1 low-grade adenosquamous carcinoma and 1 myoepithelial carcinoma underwent MRI, all present as long T1 and T2 signal lesion with high intensity on diffusion weighted imaging and uniform or uneven enhancement. Conclusion Ultrasonic and MRI manifestations of different pathological types MCB had certain characteristics.