乳腺包裹性乳头状癌MRI表现

目的 观察乳腺包裹性乳头状癌（EPC）MRI表现。方法 回顾性分析18例经手术病理证实的乳腺EPC患者，比较单纯EPC组（7例）与EPC伴浸润或导管原位癌（DCIS）组（11例）的差异。结果 18例EPC均表现为乳腺肿块，5例伴非肿块样强化；其中囊实性肿块11例，实性肿块7例；10例呈圆形/卵圆形，8例不规则；11例边界清楚，7例不清楚；EPC实性部分ADC值中位数为1.12×10^-3 mm²/s。时间-强度曲线（TIC）流出型13例，平台型5例；15例可见延迟强化包膜，其中13例平扫T2WI呈低信号；邻近血管征（AVS）阳性16例，阴性2例。单纯EPC与EPC伴浸润或DCIS临床及MRI表现差异无统计学意义。结论 乳腺EPC的MRI表现有一定特征，主要为边界清楚的囊实性肿块，T2WI周围见低信号包膜，增强扫描可见延迟强化，TIC以流出型为主，AVS表现阳性。

MRI manifestations of breast encapsulated papillary carcinoma

Objective To explore MRI manifestations of breast encapsulated papillary carcinoma (EPC). Methods Data of 18 women with EPC confirmed by surgery and pathology were retrospectively analyzed. Pure EPC (n=7) and EPC with invasion or ductal carcinoma in situ (DCIS) (n=11) were compared. Results All 18 EPC presented as masses, and 5 were accompanied by non-mass enhancement. Totally 11 masses were mixed cystic-solid and 7 purely solid, 10 were round/oval and 8 were irregular, 11 were margins circumscribed and 7 were irregular. The median apparent diffusion coefficient (ADC) value of the solid part of EPC was 1.12×10^-3 mm²/s. The time-intensity curve (TIC) of EPC was washout in 13 cases and plateau in 5 cases. Delayed-enhancement capsules were observed in 15 masses, included 13 masses showing hypointense capsules on T2WI. The adjacent vessel sign (AVS) was present in 16 masses. No significant difference of clinical nor MRI features was found between pure EPC and EPC with invasion or DCIS. Conclusion MRI findings of breast EPC were of certain characteristics, commonly manifested by mixed cystic-solid mass with circumscribed margin, delayed-enhancement capsules presenting hypointense on T2WI, washout TIC type and AVS positive.