原发性乳腺淋巴瘤的CT及MR表现

目的探讨原发性乳腺淋巴瘤的CT及MR特征,提高对本病影像学表现的认识。方法回顾性分析经病理证实的14例原发性乳腺淋巴瘤患者的CT及MR资料,年龄32～77岁,中位年龄54岁。所有患者皆行CT增强扫描,其中6例行MR检查。结果14例病灶大小2．2～11．5cm。所有病变密度或信号均匀,未见毛刺及钙化。其主要有三种表现：①单发结节或肿块型：占64．3％（9/14）。增强CT除1例呈环形伴结节样强化外,其他皆均匀中等度强化。乳头未见凹陷,皮肤未见增厚,乳后间隙未见侵犯。MRI脂肪抑制T。wI表现为稍高信号,DWl显示扩散明显受限,ADC值显著降低,约0．45×10^-3m㎡/s～0．73×10^-3m㎡/s,时间～信号曲线均呈平台型（Ⅱ型）曲线;②多发肿块型：占14．3％（2/14）。病灶直径较大,为数个结节融合所致。密度信号改变同单发结节或肿块型相似,但占位效应明显,乳后问隙狭窄;③弥漫型：占21．4％（3/14）。病灶直径巨大,范围广泛,可累及两个乳腺象限至整个乳腺,占位效应最明显。病灶强化不均匀,MR脂肪抑制T2WI见高信号分隔,增强后分隔明显强化,可伴有乳后间隙受侵,皮肤广泛增厚,但乳头未见凹陷。结论原发性乳腺淋巴瘤的影像学表现具有一定的特征性。当出现乳腺内无毛刺及钙化的结节、肿块,MRIT2WI脂肪抑制序列呈稍高信号,ADC值显著降低、或伴一侧乳腺皮肤广泛增厚而无乳头凹陷,应考虑原发性乳腺淋巴瘤可能。     

原发性乳腺恶性淋巴瘤的影像学研究进展

原发性乳腺恶性淋巴瘤是罕见的结外原发性淋巴瘤,占所有结外原发性非霍奇金淋巴瘤的1.7%～2.2%,占乳腺恶性肿瘤的0.04%～1.1%。乳腺X线检查、超声、MRI及PET等影像学检查是其目前主要的检查方法。通过复习近年大量文献,对各种影像学检查方法进行了对比,每种影像学检查方法在原发性乳腺恶性淋巴瘤的诊断中各具优势及其局限性,多种检查方法的互补应用更有利于疾病的诊断。     

5307名女性乳腺首次筛查影像结果分析

目的 探讨X线、超声和体检3种筛查组合方法对早期乳腺癌检出的意义,分析筛查癌的特点.方法 对5307名女性乳腺进行初次筛查,受检者年龄20～76岁(中位年龄49岁).分析X线加超声和体检、X线加体检、X线检查3种筛查组合的回叫率、活检率和癌检出率,并对筛查癌进行影像分析.各组间比较使用行×列的X2检验或者Fisher's精确检验.结果 X线加超声和体检、X线加体检、X线检查3种筛查组合比较如下:回叫率分别为4.90%(49/1001)、6.90%(166/2407)、4.48%(85/1899);活检率为1.60%(16/1001)、1.04%(25/2407)、0.163%(12/1899);癌检出率为0.50%(5/1001)、0.17%(4/2407)、0(0/1899).X线加超声和体格检查的癌检出率最高,共发现10例乳腺癌,其中9例为筛检癌.3组间的回叫率、活检率和癌检出率比较差异均有统计学意义(X2值分别为12.99、6.264、8.764,P值均<0.05).筛检癌中8例为早期乳腺癌(导管原位癌4例,Ⅰ期浸润性乳腺癌4例).X线检出的7例病灶中仅2例被超声发现,其他5例超声和体检均未检出.表现为簇状分布的多形性钙化2例,交界性钙化呈线样分布2例,不对称致密、不对称致密伴钙化、多簇状钙化伴多发结节各1例.X线漏诊的2例经回顾性阅片都予以正确诊断,均表现为非对称致密影.结论 X线加超声和体格检查3者组合是乳腺癌筛查的最佳组合,X线检查检出的病灶较其他方法更为早期.     

Imaging of the male breast

Very few studies have dealt with the male breast, in particular as compared with the female breast, no doubt as a result of the high incidence and mortality of breast cancer in women. However, in routine practice breast radiologists are often faced with male breast disorders, but often have difficulties because of the limited experience in this field. The purpose of this pictorial essay is to summarise the clinical, pathophysiological, radiological and ultrasonographic patterns of male breast disorders based on a review of personal cases (398 cases from 1993 to 2004), in an attempt to propose guidelines for a more consistent approach to this only apparently marginal branch of male pathology.     

Preoperative breast MR Imaging in patients with primary breast cancer has the potential to decrease the rate of repeated surgeries

PurposeThe impact of preoperative MRI on re-excisions and mastectomy rate is discussed controversially in the literature. Aim of this study was to evaluate the effect of preoperative breast MRI on the surgical procedure and rate of repeated surgeries.Material and methodsA total of 991 consecutive patients in the years 2009 and 2010 with 1036 primary breast cancers were retrospectively analyzed. Sixty percent (599 patients with 626 cancers) received preoperative breast MRI. Planned surgical procedures before and after MRI and numbers of repeated surgeries in patients with (MR+ ) and without preoperative MRI (MR−) were compared.ResultsThe result of preoperative MRI changed the surgical procedure in 25% (157/626) of the cases. In 81% (127/157), MRI was beneficial for the patients, as otherwise occult carcinomas were removed (n = 122) or further biopsy could be prevented (n = 5). Mastectomy rates did not differ between MR+ and MR- group (39% vs. 39%). On multiple regression analysis, the MR+ group had a lower chance for repeated surgery (p < 0.05).ConclusionPreoperative MRI could lower the chance for repeated surgery in patients with primary breast cancer. The rate of mastectomy did not differ between patients undergoing preoperative MRI and those who did not.     

Imaging breast cancer

Imaging has a significant role in diagnosing, treating, and monitoring breast cancer. Advances in this field are having a great impact in the clinical management of this disease. Breast cancer has now become an "outpatient cancer". This article describes the role and advances of imaging in breast cancer.     

Imaging of breast masses

The American College of Radiology Breast Imaging and Reporting Data System (ACR BI-RADS) defines a mass as a space-occupying lesion seen in at least two projections. This article focuses on the management of breast masses with mammography and ultrasonography. Recommended work-up pathways are modified for nonpalpable masses, palpable masses in women over the age of 30, and palpable masses in women under the age of 30. The suggested protocols are based on scientific peer-reviewed literature whenever possible, but when evidence based studies are not available, the author relies on expert opinion.     

Myofibroblastoma of the breast: Imaging features

Myofibroblastoma of the breast is a rare, benign mesenchymal neoplasm. To our knowledge, there have been few reports describing the imaging features of this type of tumor. We report a case of myofibroblastoma in a 68-year-old woman, emphasizing the mammography and sonography findings of the tumor which mimicked a hamartoma in this case. Myofibroblastoma has a variable appearance on mammography and sonography. This rare diagnosis should be considered for a slow-growing mass in a male or post-menopausal female. The treatment is local excision.     

原发性胆囊癌的影像学诊断(附52例分析)

目的:探讨超声、CT和MRI在胆囊癌诊断中的临床应用价值。方法:回顾性分析52例经手术及病理证实的胆囊癌的超声、CT和MRI资料。结果:52例胆囊癌术前超声诊断符合率为73.1%(38/52),CT诊断符合率为75%(39/52),MRI符合率为83.3%(15/18)。其中合并慢性胆囊炎伴胆囊结石21例(40.4%)。影像表现为4种类型:胆囊壁增厚型(16例),乳头结节型(15例),混合型(壁厚和结节8例),实体型(13例)。结论:超声、CT和MRI对胆囊癌的诊断具有重要的临床价值,合理的应用能更好地指导临床治疗和术后疗效观察。     

Imaging male breast cancer

Male breast cancer is rare, with some pathological and radiological differences from female breast cancer. There is less familiarity with the imaging appearances of male breast cancer, due to its rarity and the more variable use of preoperative imaging. This review will illustrate the commonest imaging appearances of male breast cancer, with emphasis on differences from female breast cancer and potential pitfalls in diagnosis, based on a 10 year experience in our institution.     

乳腺癌的影像学检查

随着现代影像技术的长足发展，以钼靶检查为主、诸多检查手段已用于乳腺癌的筛查，本文就各种乳腺影像检查的特点作一综述。     

原发性软骨肉瘤的影像诊断

目的探讨原发性软骨肉瘤影像特点及诊断要点。方法回顾性分析13例病理证实的原发性软骨肉瘤的X线、CT、MRI表现,并与病理对照。结果13例中,常见型9例,黏液型3例,去分化型1例。发病部位：长骨7例（股骨6例,肱骨上端1例）,躯干骨6例（骨盆3例,肋骨2例,胸椎1例）。X线及CT表现：呈斑片状、大片状溶骨性骨质破坏,周围骨质密度增高,骨皮质破坏、中断,局部软组织肿块。11例病灶内出现钙化。MRI表现：5例病灶T1WI呈稍低及等信号,T2WI呈显著高信号,增强后呈分隔状强化。结论X线、CT、MRI检查的综合运用,对原发性软骨肉瘤的诊断有重要的价值。