乳腺浸润性导管癌动态增强MRI诊断

目的探讨动态增强MRI对乳腺浸润性导管癌的诊断价值。方法回顾性分析经手术病理证实的15例乳腺浸润性导管癌患者的MRI资料,所有病例均经平扫和动态增强扫描,着重从病灶的MRI信号强度、形态学及血液动力学特点三个方面分析。结果 10例术前诊断与术后病理一致。15例乳腺浸润性导管癌分为肿块型（11例）和非肿块型（4例）,T1WI呈低信号影（8例）、等信号影（7例）,T2WI抑脂呈等信号影（9例）、高信号影（6例）。形态学表现：肿块型病变表现为边缘不光滑呈分叶状,其中毛刺征或星芒征（9例）;非肿块型表现为导管状及簇集样不规则分布（3例）。增强后病灶以早期不均匀性显著强化为主（10例）、延迟环形强化（7例）;伴随征象包括乳头凹陷（4例）、皮肤增厚（6例）、乳后脂肪间隙中断（3例）等。血液动力学表现：15例病灶SIR在169.36%-301.23%之间,平均198.23%,最大峰值出现在第二个时相（13例）、出现在第三时相（2例）,时间-信号曲线为Ⅱ、Ⅲ型,Ⅱ型（6例）,Ⅲ型（9例）。结论动态增强MRI对乳腺浸润性导管癌的诊断具有重要作用,术前正确诊断率约66.7%。

Diagnose of Dynamic Enhanced MRI in Invasive Ductal Carcinoma of Breast

Objective To investigate the diagnostic value of dynamic enhanced MRI in the breast invasive ductal carcinoma. Methods 15 cases of patients with breast invasive ductal carcinoma who underwent MRI plain and dynamic enhanced scan, confirmed by pathology, were retrospectively analyzed, emphasized on signal intensity, morphological and hemodynamic characteristics. Results The preoperative diagnosis is in according with postoperative pathology in 10 cases. 15 cases of breast invasive ductal carcinoma were divided into mass type （11 cases） and non-mass type （4 cases）;There were low signal （8 cases） and iso-intensity （7 cases） in T1WI images wihle iso-intensity （9 cases） or high signal （6 cases） in T2WI images with fat suppression. Morphological manifestations：mass type lesions showed the rough edge and lobulated, in those lesions,the spicule sign （9 cases） were found while non-mass type showed the irregular cluster distribution （3 cases）. About the enhanced lesions, obvious non-uniformity enhancement in the early phase（10 cases）, ring-enhancement in the delay phase （7 cases）, Accompany signs included crater nipple （4 cases）, skin thickening （6 cases）, fat clearance of the breast base interruption （3 cases）.Hemodynamic performance：SIR of lesions was between 169.36%-169.36%, average 198.23%in 15 cases, maximum peak appeared in the second phase （13 cases）and the third phase （2 cases）, the time-signal curve was typeⅡ（6 cases）andⅢtype （9 cases）. Conclusion Dynamic enhanced MRI plays an important role in the diagnosis of breast invasive ductal carcinoma. The Preoperative correct diagnosis rate is about 66.7%.