CAJ | 학술논문

目的：探讨动态增强MRI对乳腺浸润性导管癌的诊断价值。方法回顾性分析经手术病理证实的15例乳腺浸润性导管癌患者的MRI资料，所有病例均经平扫和动态增强扫描，着重从病灶的MRI信号强度、形态学及血液动力学特点三个方面分析。结果10例术前诊断与术后病理一致。15例乳腺浸润性导管癌分为肿块型(11例)和非肿块型(4例)，T1WI呈低信号影(8例)、等信号影(7例)，T2WI抑脂呈等信号影(9例)、高信号影(6例)。形态学表现：肿块型病变表现为边缘不光滑呈分叶状，其中毛刺征或星芒征(9例)；非肿块型表现为导管状及簇集样不规则分布(3例)。增强后病灶以早期不均匀性显著强化为主(10例)、延迟环形强化(7例)；伴随征象包括乳头凹陷(4例)、皮肤增厚(6例)、乳后脂肪间隙中断(3例)等。血液动力学表现：15例病灶SIR在169.36％-301.23％之间,平均198.23％，最大峰值出现在第二个时相(13例)、出现在第三时相(2例)，时间-信号曲线为Ⅱ、Ⅲ型，Ⅱ型(6例)，Ⅲ型(9例)。结论动态增强MRI对乳腺浸润性导管癌的诊断具有重要作用，术前正确诊断率约66.7%。
목적：탐토동태증강MRI대유선침윤성도관암적진단개치。방법회고성분석경수술병리증실적15례유선침윤성도관암환자적MRI자료，소유병례균경평소화동태증강소묘，착중종병조적MRI신호강도、형태학급혈액동역학특점삼개방면분석。결과10례술전진단여술후병리일치。15례유선침윤성도관암분위종괴형(11례)화비종괴형(4례)，T1WI정저신호영(8례)、등신호영(7례)，T2WI억지정등신호영(9례)、고신호영(6례)。형태학표현：종괴형병변표현위변연불광활정분협상，기중모자정혹성망정(9례)；비종괴형표현위도관상급족집양불규칙분포(3례)。증강후병조이조기불균균성현저강화위주(10례)、연지배형강화(7례)；반수정상포괄유두요함(4례)、피부증후(6례)、유후지방간극중단(3례)등。혈액동역학표현：15례병조SIR재169.36％-301.23％지간,평균198.23％，최대봉치출현재제이개시상(13례)、출현재제삼시상(2례)，시간-신호곡선위Ⅱ、Ⅲ형，Ⅱ형(6례)，Ⅲ형(9례)。결론동태증강MRI대유선침윤성도관암적진단구유중요작용，술전정학진단솔약66.7%。
Objective To investigate the diagnostic value of dynamic enhanced MRI in the breast invasive ductal carcinoma. Methods 15 cases of patients with breast invasive ductal carcinoma who underwent MRI plain and dynamic enhanced scan, confirmed by pathology, were retrospectively analyzed, emphasized on signal intensity, morphological and hemodynamic characteristics. Results The preoperative diagnosis is in according with postoperative pathology in 10 cases. 15 cases of breast invasive ductal carcinoma were divided into mass type (11 cases) and non-mass type (4 cases);There were low signal (8 cases) and iso-intensity (7 cases) in T1WI images wihle iso-intensity (9 cases) or high signal (6 cases) in T2WI images with fat suppression. Morphological manifestations:mass type lesions showed the rough edge and lobulated, in those lesions,the spicule sign (9 cases) were found while non-mass type showed the irregular cluster distribution (3 cases). About the enhanced lesions, obvious non-uniformity enhancement in the early phase(10 cases), ring-enhancement in the delay phase (7 cases), Accompany signs included crater nipple (4 cases), skin thickening (6 cases), fat clearance of the breast base interruption (3 cases).Hemodynamic performance:SIR of lesions was between 169.36%-169.36%, average 198.23%in 15 cases, maximum peak appeared in the second phase (13 cases)and the third phase (2 cases), the time-signal curve was typeⅡ(6 cases)andⅢtype (9 cases). Conclusion Dynamic enhanced MRI plays an important role in the diagnosis of breast invasive ductal carcinoma. The Preoperative correct diagnosis rate is about 66.7%.