乳腺原位癌MRI表现和诊断价值

目的：探讨MRI对乳腺原位癌的诊断价值。方法：回顾性分析9例经病理学证实的乳腺原住癌的MRI表现，所有患者均行MRI平扫及灌注成像。结果：所有病变于T1WI呈低信号，7例T2WI呈混杂稍高信号或高信号、2例呈等信号。增强扫描示6例呈非肿块样强化，其中2例呈线样／导管样强化，3例呈斑片状强化，1例为弥漫性强化；3例呈肿块样强化。时间-信号强度曲线：平台型7例，上升型1例，廓清型1例。灌注成像测量的灌注参数包括洗进（Washin）、洗出（Washout）、达峰时间（TTP）、最大信号强度值（MIPt）及阳性强化积分（PEI），其均值依次为756．84±48．70、-0．0856±8．99、248．51±22．52、464．51±28．43、1282．11±96．86，与正常乳腺组织各参数值比较差异均有统计学意义（P〈0．05）。结论：乳腺原位癌以局灶性强化最常见，时间-信号强度曲线以平台型为主，MRI在乳腺原位癌诊断中具有一定的价值，MR灌注成像也为原位癌的诊断提供一种新的方法。

MRI feature and diagnosis of breast carcinoma in situ

Objective：To assess the value of MR imaging in the diagnosis of breast carcinoma in situ （CIS）. Methods： MRI of 9 cases of breast CIS confirmed by histopathologic findings were analyzed retrospectivly. Results： All nine cases showed low signal on T1 WI, on T2 WI 7 cases showed high signal and mixed higher signals, 2 cases showed equal signal. Af- ter contrast administration,6 cases showed a non-mass-like enhancement,2 cases showed linear-ductal-like enhancement, 3 cases showed patchy enhancement, 1 case showed diffuse enhancement. 3 cases showed a mass-like enhancement. Time-sig naI intensity curves （TIC） of 7 lesions were plateau,1 lesion was wash-in,and 1 lesion was wash-out. Pseudo-color pictures of breast perfusion：Washin,Washout, TTP, MIPt and PEI values of breast CIS were 756.84 ±48.70.- 0. 0856±8. 99. 248.51±22.52,464.51±28.43 and 1282.11±96.86, there were significant difference between the breast carcinoma in situ and normal breast tissue（P〈0.05）. Conclusion： Focal enhancement is the most common morphological characteristics of breast CIS,type Ⅱ TIC is the most common types. MRI in the diagnosis of breast carcinoma in situ has certain effect, perfu- sion imaging for the diagnosis of carcinoma in situ provides a new approach.