CAJ | 학술논문

目的：总结乳腺导管内乳头状瘤的MR影像特征，提高其MRI诊断水平。材料与方法与术后病理对照，回顾性分析我院76例(7例双侧乳腺患病，共83侧)乳腺导管内乳头状瘤患者的术前MR图像，总结该病变的形态学特点、内部强化方式、血液动力学特征及其在T2WI、扩散加权成像(DWI)上的信号特点。结果病变最大径为0.2～9.8 cm，平均1.3 cm。病变形态：类圆形51侧，椭圆形13侧，不规则形11侧，分叶状8侧。病变边界：清楚73侧，不清楚10侧。病变T2WI脂肪抑制的信号特点：等高混杂信号40侧，等信号34侧，高信号9侧。病变DWI信号特点：76例中3例(均为单侧乳腺病变)DWI失败；80侧病变：高信号59侧，等信号21侧；病变ADC值范围为0.82×10-3 mm2/s～1.42×10-3 mm2/s，平均ADC值为1.15×10-3 mm2/s (正常乳腺ADC范围为1.03×10-3 mm2/s～1.98×10-3 mm2/s，平均为1.53×10-3 mm2/s)。病变内部强化方式：均匀明显强化50侧，不均匀强化33侧。病变时间-信号强度曲线类型：流出型33侧，缓升型28侧，平台型22侧。病变伴有导管扩张16侧(其中囊实性者11侧)。结论乳腺导管内乳头状瘤的MRI表现具有以下特征：病灶多为边界清楚的圆形、类圆形均匀强化结节，T2WI以等高混杂或等信号为主，上述特征有助于正确诊断。
목적：총결유선도관내유두상류적MR영상특정，제고기MRI진단수평。재료여방법여술후병리대조，회고성분석아원76례(7례쌍측유선환병，공83측)유선도관내유두상류환자적술전MR도상，총결해병변적형태학특점、내부강화방식、혈액동역학특정급기재T2WI、확산가권성상(DWI)상적신호특점。결과병변최대경위0.2～9.8 cm，평균1.3 cm。병변형태：류원형51측，타원형13측，불규칙형11측，분협상8측。병변변계：청초73측，불청초10측。병변T2WI지방억제적신호특점：등고혼잡신호40측，등신호34측，고신호9측。병변DWI신호특점：76례중3례(균위단측유선병변)DWI실패；80측병변：고신호59측，등신호21측；병변ADC치범위위0.82×10-3 mm2/s～1.42×10-3 mm2/s，평균ADC치위1.15×10-3 mm2/s (정상유선ADC범위위1.03×10-3 mm2/s～1.98×10-3 mm2/s，평균위1.53×10-3 mm2/s)。병변내부강화방식：균균명현강화50측，불균균강화33측。병변시간-신호강도곡선류형：류출형33측，완승형28측，평태형22측。병변반유도관확장16측(기중낭실성자11측)。결론유선도관내유두상류적MRI표현구유이하특정：병조다위변계청초적원형、류원형균균강화결절，T2WI이등고혼잡혹등신호위주，상술특정유조우정학진단。
Objective: To investigate the clinical characteristics of magnetic resonance imaging (MRI) for the breast intraductal papilloma, and to help improve the diagnostic accuracy of the MRI for this lesion. Materials and Methods:Postoperative pathology was used as the gold standard, a total of 76 patients with breast intraductal papillom were collected, including 7 patients with bilateral breast neoplasms. Clinical characteristics of the preoperative MRI image data were analyzed, including morphological features of the lesion, the signal characteristics of the lesion for T2WI and diffusion weighted imaging (DWI), the internal reinforcement method, and the characteristics of hemodynamics. Results:The average largest diameter line of the lesions was 1.3 cm, range from 0.2 cm to 9.8 cm. Morphology of the lesions were summarized as follows:round 51 cases, elliptic 13 cases, irregularly shaped 11 cases, lobulated 8 cases. Seventy-three cases showed clear margin while the other 10 cases didn’t. For the fat suppressed signal on T2WI, the number of cases with mixed hyper-intensity, iso-intensity, and hyper-intensity was 40, 34 and 9, respectively. There were 3 patients with unilateral lesion didn’t get the DWI result, 59 cases showed hyper-intensity, and 21 cases showed iso-intensity on DWI. The average value of apparent diffusion coefifcients (ADC) of the lesions was 1.15×10-3 mm2/s, ranges from 0.82× 10-3 mm2/s to 1.42×10-3 mm2/s. Fifty cases showed homogeneous enhancement and the other 33 showed heterogeneous enhancement. For the type of time-signal intensity curve, numbers of platform, outflow and sustained ascending was 22, 33, and 28, respectively. There were 16 cases in association with duct dilatation, among which 11 cases were cystic and solid. Conclusions:The characteristics of the MRI for the breast intraductal papilloms generally present as round lesion with clear margin, mixed hyper-or iso-intensity on T2WI, and with homogeneous enhancement. All these characteristics are valuable for accurate diagnosis.