乳腺黏液腺癌的影像学特征和诊断价值

目的 探讨单纯型乳腺黏液腺癌(PMBC)和混合型乳腺黏液腺癌(MMBC)的影像学特征,评价超声、X线、MRI对乳腺黏液腺癌(MBC)的诊断价值.方法 回顾经手术病理证实的48例MBC患者术前的影像资料,分析PMBC和MMBC的超声、X线、MRI影像特征,进一步比较3种影像学的诊断价值.结果 在3种影像学检查中,PMBC多表现为规则的肿块(圆形、椭圆形或分叶状),边缘清晰;而MMBC多表现为不规则肿块,边缘呈浸润征象.在超声声像图中,MBC更多表现为囊实混合性回声,PMBC多表现为血供不丰富、后方回声增强;而MMBC大多血供丰富,后方回声不一.在MRI中,MBC在T2 WI上表现为高信号或明显高信号,在增强方式上,PMBC更多表现为边缘强化,以渐进性强化方式主,而MMBC更多表现为边缘强化或不均匀强化,以平台型强化方式为主.3种检查方法对2种类型的诊断准确率比较无差异,3种检查方法之间的诊断准确率比较也无统计学意义.结论 PMBC和MMBC在超声、X线、MRI影像上的表现各具有其一定的特征性,充分认识其影像学特征不仅能提供鉴别2种类型的依据,还能减少MBC的漏诊和误诊.

Manifestations and imaging diagnostic value of mucinous carcinoma of the breast

Objective To explore the mixed mucinous breast carcinomas(MMBC)and pure mucinous breast carcinomas(PMBC) imaging features,and evaluate the diagnostic value of ultrasound,X-ray and MRI for mucinous breast carcinoma(MBC).Methods Totally 48 cases of MBC proved by postoperative pathology were analyzed retrospectively.Manifestations of ultrasonography,X-ray and MRI of MMBC and PMBC were summarized,and diagnostic values of three methods were compared.Results Most PMBC showed regular shaped (round,oval or lobulated)mass with clear edge,but most MMBC showed irregular shaped mass with unclear edge in three imaging examinations.On sonogram,MBC mainly showed mixed cystic-solid echo,most PMBC showed low blood signal with rear echo enhancement,and most MMBC showed rich blood signal with various rear echo.On MRI,MBC usually demonstrated high or strongly high signal intensity on T2 WI.On DCE-MRI,PMBC was mainly characterized by rim enhancement with persistent enhancement pattern, and MMBC was exhibited more heterogeneous or rim enhancement with plateau enhancement pattern.Three imaging methods were no significant difference in the accuracy of diagnosis between PMBC and MMBC.There was no statistical significance in three imaging methods.Conclusion PMBC and MMBC with different the appearances of ultrasonography,X-ray and MRI have some characteristics.Fully aware of imaging features can not only identify two types of MBC,but also reduce missed diagnosis and misdiagnosis of MBC.