CAJ | 학술논문

目的探讨乳腺导管乳头状瘤(IP)的MRI表现,提高对IP的认识和术前诊断准确性.方法回顾性分析经手术病理证实的24例IP的MRI表现,包括形态学、平扫信号强度、增强扫描病变内部强化方式及其动态变化特征和时间-信号强度曲线(TIC)类型、DWI上ADC值.采用配对设计资料t检验比较IP和正常乳腺组织ADC值的差异.结果 24例IP最大径0.3～2.0 cm.17例呈圆形或卵圆形,7例不规则形;边界18例清晰,6例欠清.平扫T1WI呈等或稍低信号,T2WI呈稍高信号.动态增强扫捕早期时相肿瘤均明显强化,15例呈较均匀强化,9例强化欠均匀,早期强化率平均值为(156.50±19.67)%,延迟时相18例表现为肿瘤边缘部分信号强度高于中心部分,而呈"环形"表现.TIC 19例旱Ⅲ型,5例呈Ⅱ型.b值为1000 s/ram2时,平均ADC值为(1.14±0.29)×10-3mm2/s,低于正常乳腺组织的ADC值[(1.83±0.32)×10-3mm2/s],差异有统计学意义(t=5.53,P=0.000).结论 IP的动态增强扫描TIC类型和DWI上ADC值表现与乳腺癌相似,动态增强扫描早期强化率和内部强化方式的动态变化特征上具有特征性.
목적 탐토유선도관유두상류(IP)적MRI표현,제고대IP적인식화술전진단준학성.방법 회고성분석경수술병리증실적24례IP적MRI표현,포괄형태학、평소신호강도、증강소묘병변내부강화방식급기동태변화특정화시간-신호강도곡선(TIC)류형、DWI상ADC치.채용배대설계자료t검험비교IP화정상유선조직ADC치적차이.결과 24례IP최대경0.3～2.0 cm.17례정원형혹란원형,7례불규칙형;변계18례청석,6례흠청.평소T1WI정등혹초저신호,T2WI정초고신호.동태증강소포조기시상종류균명현강화,15례정교균균강화,9례강화흠균균,조기강화솔평균치위(156.50±19.67)%,연지시상18례표현위종류변연부분신호강도고우중심부분,이정"배형"표현.TIC 19례한Ⅲ형,5례정Ⅱ형.b치위1000 s/ram2시,평균ADC치위(1.14±0.29)×10-3mm2/s,저우정상유선조직적ADC치[(1.83±0.32)×10-3mm2/s],차이유통계학의의(t=5.53,P=0.000).결론 IP적동태증강소묘TIC류형화DWI상ADC치표현여유선암상사,동태증강소묘조기강화솔화내부강화방식적동태변화특정상구유특정성.
Objective To characterize the MR features of intraductal papilloma of the breast.Methods The MRI data of 24 patients with intraductal papillomas of the breast verified by histopathology were analyzed.The MRI features analyzed included morphology,signal intensity on pre-enhanced T1 WI and FE T2 WI,the patterns of dynamic enhancement,and the mean ADC on DWI.The ADC values for intraductal papilloma and normal breast tissue were compared using paired t test.Results The maximum diameter of the tumors ranged from 0.3 cm to 2.0 cm.Of the 24 tumors,17 were round or oval and 7 were irregular in shape:the margins were well-defined in 18 cases,and ill-defined in 6 cases.AII tumors were isointensity or hypointensity on T1 WI,and slight hyperintensity on T2 WI.On dynamic enhanced images,all the 24 tumors showed rapid initial enhancement.and the mean early phase enhancement rate was(156.50±19.67)%.In the early phase.homogenous enhancement was shown in 15 cases and heterogeneous enhancement in 9 cases.In the delayed phases,the most tumors(18/24)had ring-like enhancement pattern in which signal intensity in peripheral is higher than that in center.The patterns of time-signal intensitycurves were type Ⅲ(washout)in 19 cases and type Ⅱ(plateau)in 5 cases.With b=1000 s/mm2,the mean ADC value for intraductal papilloma[(1.14±0.29)×10-3mm2/s]was significantly lower than that of the normal breast tissue [(1.83±0.32)x 10-3mm2/s (t=5.53,P=0.000).Conclusions MRI features of intraductal papilloma are similar to breast cancer in washout pattern on DCE-MRI and lower ADC value on DWL However,relative lower early enhancement rate and dynamic signal intensity course on DCE-MRI are characteristic clues to differentiating intraductal papilloma from breast eancer.