CAJ | 학술논문

目的：研究3.0 T磁共振动态增强扫描联合超声检查对乳腺癌的诊断价值，探讨不同分子亚型乳腺癌的影像特征。方法回顾性分析24例经手术病理证实的乳腺癌患者（30个病灶）的超声和MRI资料，所有患者均为女性，年龄39～69岁，中位年龄55岁；根据雌激素受体、孕激素受体、人表皮生长因子受体-2（HER-2）的表达状态，将乳腺癌分为三阴性、HER-2过表达和Luminal三个亚型，分析不同分子类型乳腺癌的影像表现，如回声/信号、形态、边界、钙化、强化方式、周围组织是否受侵等，重点分析MRI的时间-信号强度曲线（TIC）及超声的Adler血供分型。结果根据乳腺癌分子亚型的标准，三阴性型占3.3%（1/30）；Her-2过表达型占20.0%（6/30），Luminal型占76.7%（23/30）。术前超声单独诊断乳腺癌的准确率为76.7%（23/30），MRI单独诊断乳腺癌的准确率为86.7%（26/30），联合超声、MRI诊断乳腺癌的准确率为96.7%（29/30）。MRI的TIC以Ⅱ型、Ⅲ型居多，分别为18/30（60%）、12/30（40%），超声 Adler 血供以Ⅱ型居多（18/30，60%）；MRI的TIC对Her-2过表达及Luminal乳腺癌两种分子分型有统计学意义（P＜0.05）。结论不同分子类型乳腺癌的影像学征象各具特点；联合磁共振动态增强扫描与超声检查对乳腺癌的检出准确率均高于单独任一检查方法。
목적：연구3.0 T자공진동태증강소묘연합초성검사대유선암적진단개치，탐토불동분자아형유선암적영상특정。방법회고성분석24례경수술병리증실적유선암환자（30개병조）적초성화MRI자료，소유환자균위녀성，년령39～69세，중위년령55세；근거자격소수체、잉격소수체、인표피생장인자수체-2（HER-2）적표체상태，장유선암분위삼음성、HER-2과표체화Luminal삼개아형，분석불동분자류형유선암적영상표현，여회성/신호、형태、변계、개화、강화방식、주위조직시부수침등，중점분석MRI적시간-신호강도곡선（TIC）급초성적Adler혈공분형。결과근거유선암분자아형적표준，삼음성형점3.3%（1/30）；Her-2과표체형점20.0%（6/30），Luminal형점76.7%（23/30）。술전초성단독진단유선암적준학솔위76.7%（23/30），MRI단독진단유선암적준학솔위86.7%（26/30），연합초성、MRI진단유선암적준학솔위96.7%（29/30）。MRI적TIC이Ⅱ형、Ⅲ형거다，분별위18/30（60%）、12/30（40%），초성 Adler 혈공이Ⅱ형거다（18/30，60%）；MRI적TIC대Her-2과표체급Luminal유선암량충분자분형유통계학의의（P＜0.05）。결론불동분자류형유선암적영상학정상각구특점；연합자공진동태증강소묘여초성검사대유선암적검출준학솔균고우단독임일검사방법。
Objective To evaluate the diagnostic capability of detecting breast cancer combining ultrasound and dynamic contrast enhancement MRI and to investigate the ultrasonic and MRI features of breast cancers of different molecular subtypes.MethodsUltrasonic and MRI data of 24 patients (30 lesions) with breast cancer confirmed by pathology were retrospectively analyzed. All patients were female, aged 39-69 years, with a median age of 55 years. According to the expression of estrogen receptors, progesterone receptor and human epidermal growth factor receptor-2 (HER-2), the tumors were classified into triple-negative, HER-2 over expressed and luminal subtypes. The imaging features of different molecular subtypes breast cancers, such as the echo/signal, border, calcification, blood supply of tumor and the changes of surrounding tissue of tumors, were analyzed, especially time-signal intensity curve type in MRI and Alder blood supply type.Results There were one case of triple-negative (1/30), 6 cases of HER-2 over expressed (6/30) and 23 cases of Luminal subtypes (23/30). Diagnostic accuracy rate of breast cancer by ultrasound was 76.7%, and 86.7% by MRI, and both of them were 96.7%. There were statistical differences in TIC curve between HER-2 and Luminal subtypes (P<0.05).Conclusion Ultrasonic and MRI imaging features of different molecular subtypes breast cancers have some characteristics. Diagnostic accuracy rate of breast cancer combined ultrasound with MRI is higher than either one.