乳腺叶状肿瘤的影像学表现与病理对照分析

目的 探讨不同病理学分级的乳腺叶状肿瘤(PTs)的影像学表现,提高对PTs的认识及诊断水平.方法 回顾性分析65例经手术病理证实为PTs患者的临床及影像学资料,其中61例行超声和MRI检查,44例行X线检查,并与其病理学结果相对照.结果 (1)65例PTs患者,病理类型为良性、交界性和恶性的百分比分别为32.3%(21/65)、43.1%(28/65)和24.6%(16/65);其病灶的平均最大径分别为(4.75±2.62) cm、(5.37±3.11) cm和(4.96±3.82) cm,差异无统计学意义(F=0.247,P=0.782).(2)在44例PTs患者(包括良性16例,交界性18例,恶性10例)的X线图像上,病灶透亮晕及钙化有无在三者中差异有统计学意义(P均<0.05).(3)在61例PTs患者(包括良性19例,交界性26例,恶性16例)的声像图上,不同病理类型病灶形状差异有统计学意义(P<0.05).(4)在61例PTs患者(包括良性21例,交界性24例,恶性16例)的MRI图像上,三者在T2WI上病变内低信号分隔的有无、时间-信号强度曲线(TIC)方面差异有统计学意义(P均<0.05).结论 乳腺PTs的影像学表现有助于明确其病理学分类.

Imaging findings of breast phyllodes tumors and their correlations with pathological features

Objective To study the radiological appearance and pathological features of breast phyllodes tumors(PTs), and to enhance the knowledge of the tumor.Methods Clinical and imaging findings were reviewed retrospectively in 65 women with PTs confirmed by surgical pathology.61 patients had preoperative MRI and/or sonography, and 44 had preoperative mammography.Then these findings were compared with the pathological results.Results (1)The percentages of benign, borderline and malignant PTs were 32.3%(21/65), 43.1%(28/65) and 24.6%(16/65), respectively,and the mean maximum diameters of these lesions were (4.75±2.62) cm, (5.37±3.11) cm and (4.96±3.82) cm, respectively.There were no statistical difference in lesion's size among these three types(F=0.247,P=0.782).(2)On the mammograms of these 44 PTs(including 16 cases of benign type, 18 cases of borderline and 10 cases of malignant type), the appearances of radiolucent halo and calcification among these three types showed statistically significant differences(both P<0.05).(3)On the sonography of these 61 PTs(including 19 cases of benign type, 26 cases of borderline and 16 cases of malignant type), the shape among these three types showed statistically significant difference(P<0.05).(4)On the MRI of these 61 PTs(including 21 cases of benign type, 24 cases of borderline and 16 cases of malignant type), internal hypointense septations on T2WI and time intensity curves showed statistically significant differences among these three types(both P<0.05).Conclusion Some radiological appearances of PTs can be used to help determine the histologic subtypes of breast PTs preoperatively.