乳腺导管原位癌的MRI特点分析

目的:分析乳腺导管原位癌的影像学表现及MRI的诊断价值,以进一步提高对乳腺导管原位癌的影像学认识。材料和方法:回顾性分析18例经病理证实为乳腺导管原位癌病人的临床资料,研究其乳腺磁共振图像的形态学特点、动态增强方式及扩散加权成像特点。结果:18例导管原位癌的形态学表现及增强方式大体可分为两类。一类是非肿块型13例(72.2%),包括不规则片状6例和段状改变7例,其时间-信号强度曲线呈Ⅱ型者12例,Ⅲ型者1例;另一类表现为肿块型,5例(27.8%),时间-信号强度曲线呈Ⅰ型者1例,Ⅱ型者2例,Ⅲ型者2例。弥散加权成像发现病灶15例,检出率达83.3%,表面扩散系数(ADC)1.30×10-3mm2/s有10例。结论:乳腺导管原位癌MR图像上多表现为非肿块的段状分布及片状分布的异常强化,少数也可表现为肿块型改变,弥散加权成像在定性诊断上能起重要的辅助作用。

Analysis of MR findings in ductal carcinoma in situ

Objective To analyze the magnetic resonance imaging（MRI） findings of the breast ductal carcinoma in situ（DCIS） and the diagnostic effects of MRI.Methods The clinical and MRI of DCIS in 18 patients aided by histological findings were reviewed,and the morphological features,enhancement patterns,and apparent diffusion coefficient（ADC） of the lesions in MRI were analyzed.Results The morphological features and enhancement of DCIS on MR images could be roughly classified into two types：（1）non-mass-like lesions including segmental enhancement（7 cases,38.9%）and irregular enhancement（6 cases,33.3%）and mass lesions（5 cases,27.8%）.The Time-signal intensity curve（TIC） pattern of the non-mass-like lesions was shown to be of type Ⅱ in 12 cases and type Ⅲ in 1 case and（2） the mass lesions belonged to type Ⅰ in 1 case,type Ⅱ in 2 cases and type Ⅲ in 2 cases.Of the 15 lesions found in diffusionweighted imaging,10 lesions had ADC value 1.30×10-3 mm2/s.Conclusions There exists a correlation between the morphological features and enhancement patterns of DCIS on MR images.ADC coefficient is a useful adjuvant measure in the diagnosis of DCIS.