乳腺叶状肿瘤的乳腺X射线摄影及MRI表现

目的:探讨乳腺叶状肿瘤的乳腺X射线及MRI表现,并与病理结果对照,以期提高该病的术前诊断水平。方法:选取2014年11月至2019年2月经手术病理证实的18例乳腺叶状肿瘤患者作为研究对象,所有患者均行乳腺X射线摄影检查,5例行MRI检查,分析乳腺X射线和MRI表现。结果:乳腺X射线多表现为边界清晰的高密度肿块,分叶状14例、圆形4例,伴晕征者7例,周围伴有增粗血管影3例。MRI多表现为边界清楚的分叶状肿块,T1WI多为低信号,T2WI多为高信号,弥散加权成像多为高信号,T2WI-FS序列均出现低信号且无强化的分隔,2例T2WI-FS序列出现高信号的囊性裂隙,动态增强扫描均表现早中期明显强化。结论:乳腺叶状肿瘤影像学表现具有一定的特征性,乳腺X射线摄影诊断缺乏特异性,结合MRI检查有助于提高叶状肿瘤的诊断准确性。

Mammography and MRI manifestations for phyllodes tumor

Objective To enhance the preoperative diagnosis of phyllodes tumor by studying its mammography and MRI manifestations and comparing them with pathological examination results.Methods Eighteen phyllodes tumor patients confirmed pathologically from November 2014 to February 2019 were selected as the subjects,of whom,all the ones underwent mammography examination and 5 ones went through MRI examination.The manifestations of mammography and MRI were analyzed.Results Mammography showed high-density mass with clear boundary,lobulated in 14 cases,round in 4 cases,halo in 7 cases,and thickening vascular shadow in 3 cases;MRI found lobulated masses with clear boundary,low signal on T1WI,high signal on T2WI,high signal on diffusion weighted imaging,low signal and no enhancement separation on T2WI-FS,high signal cystic fissure on T2WI-FS in 2 cases,and obvious enhancement in early and middle stages on dynamic contrast-enhanced scan.Conclusion The imaging manifestations of the phyllodes tumor have certain characteristics,and mammography gains high accuracy for diagnosing the phyllodes tumor when combined with MRI though it lacks specificity when applied separatetly.