单纯乳腺导管内癌的3．0T MR影像表现（附97例）分析

目的 分析乳腺导管内癌（DCIS）的3.0T MRI影像学特点,探讨磁共振扩散加权成像（DWI）对DCIS的诊断价值.方法 回顾性分析单纯DCIS 97例,依据乳腺影像报告和数据系统（BI-RADS-MRI）,记录DCIS的形态学、病变强化至120s时的峰值（％）、时间-信号曲线（TIC曲线）及DWI特征.结果 97例共检出100个DCIS病灶.其中点状/斑点状病灶3个（3％）,非肿块样强化病灶83个（83％）,肿块型病灶14个（14％）.非肿块样强化病灶中,以段状（48个）和局灶区域状（22个）分布最常见,43.4％呈集簇状强化.所有病灶平均120s强化峰值为172％±54％.TIC曲线以平台型（Ⅱ型）最多见.87个病灶DWI扩散受限,肿块型与非肿块型病变平均ADC值分别为（1.07±0.22）×10-3mm2/s及（1.23±0.15）×10-3 mm2/s.结论 DCIS的典型形态为段样分布的集簇状强化,TIC常表现为Ⅱ型.DWI可提高DCIS检出的敏感性.

The imaging analysis of pure ductal carcinoma in situ on 3.0 T MRI

Objective To investigate and analyze the 3.0 T MRI features of pure ductal carcinoma in situ （DCIS）, preliminary exploring the ability of diffusion-weighted imaging （DWI） in diagnosis of DCIS. Methods 97 women with 100 histopathologically proved pure DCIS were selected. The following lesion characteristics were recorded： the morphological features, peak initial enhancement at 120 seconds, time-intensity curve （TIC） pattern, and apparent diffusion coefficient （ADC）. Results The 100 DCIS lesions were found in 97 patients, and 3% （n=3） were focus lesions, 83% （n=83） were no-mass-like lesions, 14% （n=14） were mass-like lesions. In non-mass-like lesions （n=83）, segmental （n=48） and focal-regional （n=22） were the most common distribution patterns and 43.4M （n= 36） lesions showed clustered ring enhancement or cobblestone-like enhancement. The mean peak initial enhancement at 120 seconds was 172% ± 54%. The most common type of TIC was plateau （type Ⅱ ）. 87 lesions showed hyperintense on DWI. The mean ADC value of the mass-like lesions and the no-mass-like lesions were （ 1.07 ± 0.22） × 10^-2 mm^2 /s, （ 1.23 ± 0. 15 ） × 10^-3 mm^2/s respectively. Conclusion The typical morphological characteristics of DCIS were segmental with clustered ring enhancement or cobblestone-like enhancement. Type Ⅱ are the most common TIC types. These preliminary results suggest that diffusion-weighted MR imaging could be used to improve the sensitivity of DCIS detection.