CAJ | 학술논문

目的：探讨原发隐匿性乳腺肿瘤的核磁共振成像（MRI）特点，病理学相关性，以及早期诊断的准确性，为临床实践提供理论依据。方法回顾性分析2010年1月～2014年6月期间来深圳市龙岗区中医院就诊的20例乳腺肿瘤患者的MRI特点，将报告结果与术后病理类型和组织学分化进行对比，其中恶性肿瘤概率根据BIRADS分类评估。结果 MRI检出可疑病变15例，病变大小0.4～7 cm（中位数1.5 cm），其中单个病灶6例（40%），3个多灶性病变（20%），多中心病变4例（27%），双侧乳腺病变2例（13%）。13例患者MRI诊断为原发性乳腺癌，根据术后病理活检对比得，6例（67%）正确估计病变程度，1例（11%）低估了疾病范围，2例（22%）高估了疾病范围。4例患者接受切片检查后化疗，1例为中心病灶，1例为多发性疾病。2例 MRI表现为一个假阴性，1例为假阳性。结论 MRI检测原发肿瘤敏感，有利于评估肿瘤范围。双侧乳腺MRI检查是评估女性转移性乳腺癌和原发性隐匿性乳腺癌的可靠手段。
목적：탐토원발은닉성유선종류적핵자공진성상（MRI）특점，병이학상관성，이급조기진단적준학성，위림상실천제공이론의거。방법회고성분석2010년1월～2014년6월기간래심수시룡강구중의원취진적20례유선종류환자적MRI특점，장보고결과여술후병리류형화조직학분화진행대비，기중악성종류개솔근거BIRADS분류평고。결과 MRI검출가의병변15례，병변대소0.4～7 cm（중위수1.5 cm），기중단개병조6례（40%），3개다조성병변（20%），다중심병변4례（27%），쌍측유선병변2례（13%）。13례환자MRI진단위원발성유선암，근거술후병리활검대비득，6례（67%）정학고계병변정도，1례（11%）저고료질병범위，2례（22%）고고료질병범위。4례환자접수절편검사후화료，1례위중심병조，1례위다발성질병。2례 MRI표현위일개가음성，1례위가양성。결론 MRI검측원발종류민감，유리우평고종류범위。쌍측유선MRI검사시평고녀성전이성유선암화원발성은닉성유선암적가고수단。
Objective To assess the role of breast MRI in women with metastatic carcinoma and an occult primary, and to deifne the MRI characteristics of the primary breast tumor. Methods This retrospective study evaluated 20 women with metastatic carcinoma of unknown origin who underwent breast MRI from January 2010 to June 2014. Four women were excluded, leaving 16 in the study group. Probability of malignancy was assessed according to BIRADS classiifcation. MRI performance in detecting lesions and evaluating disease extent was assessed, with the gold standard being surgical or biopsy pathology. Results MRI detected suspicious lesions in 15 patients. Lesion size ranged from 0.4 to 7 cm (median 1.5 cm). MRI detected a single lesion in 6 patients (40%), multifocal disease in 3 (20%), multicentric disease in 4 (27%), and bilateral breast lesions in 2 (13%). In 13 patients MRI depicted the primary breast cancer. Initial treatment was surgical in nine;MRI correctly estimated disease extent in 6 (67%), underestimated disease extent in 1 (11%), and overestimated it in 2 (22%). Four patients had biopsy followed by chemotherapy;One had multicentric disease and one had multifocal disease. MR ifndings were false positive in two patients and false negative in one. Conclusion MRI is sensitive in detecting the primary tumor and beneifcial in assessing tumor extent. Small size and multiple foci are common features. We suggest that bilateral breast MRI be part of the evaluation of women with metastatic carcinoma and an occult primary.