钼靶与磁共振诊断乳腺叶状肿瘤的影像价值

目的探讨X线钼靶与磁共振(MRI)诊断乳腺叶状肿瘤(phyllodes tumor,PT)的影像价值。方法选取2012年4月至2015年4月医院19例经临床病理证实为PT患者作为研究对象,均行X线钼靶、MRI检查,分析影像学表现。结果手术病理显示,12例为良性,4例交界性,3例恶性。X线钼靶上3例圆形,16例分叶状,病灶密度高于周围腺体,10例见清晰边界,7例肿块周边有环形低密度影,2例无清晰边界。MRI上5例圆形,14例分叶状,平扫T1等信号或低信号,T2高信号,以信号均匀为主,4例囊变,2例出血。动态增强扫描显示以均匀明显强化为主,时间-信号曲线扫描显示6例上升型,11例平台型,2例为流出型。b值为0s/mm2时,DWI高信号;b值为500s/mm2时,12例高信号,7例低信号,对应ADC值明显高于对侧正常乳腺组织(P0.05)。结论乳腺叶状肿瘤在X线钼靶与MRI上均具有一定特征性,尤其是MRI动态增强扫描,但确诊仍依赖临床病理检查。

Imaging Value of Molybdenum Target and Magnetic Resonance in the Diagnosis of Phyllodes Tumor of Breast

Objective To explore image value of molybdenum target X-ray and magnetic resonance imaging (MRI) in diagnosis of phyllodes tumor of breast (PT).Methods 19 PT patients confirmed by clinical pathology in our hospital from April 2012 to April 2015 were selected as the research objects, they all received molybdenum target X-ray and MRI imaging examination, imaging features were analyzed.Results Surgical pathology showed that 12 cases were benign, 4 cases were borderline, and 3 cases were malignant. Molybdenum target X-ray showed that there were 3 cases in circular, 16 cases in lobulated, density of lesions was higher than body of gland around, 10 cases with clear boundary, there were annular low-density shadow around lumps in 7 cases, 2 cases without clear boundary. MRI showed that there were 5 cases in circular, 14 cases in lobulated, plain scan T1 equisignal or low signal, T2 high signal, mostly in signal uniformity, 4 cases were cystic change, 2 cases were haemorrhage. Dynamic contrast scanning showed that there mainly were homogeneous enhancement, time-signal intensity curves scan showed 6 cases were ascending type, 11 cases were platform type and 2 cases were outflow type. When b value was 0s/mm2, DWI was high signal, when b value was 500s/mm2, 12 cases were high signal, 7 cases were low signal, corresponding ADC value was significantly higher than normal breast tissue offside (P<0.05).Conclusion Phyllodes tumor of breast has certain characteristics in molybdenum target X-ray and MRI, especially in MRI dynamic contrast scanning, but diagnosis still rely on clinical pathological examination.