摘要
目的分析X线假阴性乳腺癌的MRI特征。资料与方法回顾性分析X线诊断为乳腺影像报告和数据系统(BI-RADS)1类或2类,但病理证实为乳腺癌患者23例(假阴性组);连续纳入同期X线诊断为BI-RADS 4C或5类的病例30例(对照组)。两组患者均在乳腺X线检查后1周内行乳腺MRI检查,比较两组乳腺癌的MRI特征。结果假阴性组与对照组腺体类型差异有统计学意义(P=0.04),病灶平均体积差异有统计学意义[(3.51±0.12)cm^3比(23.93±7.25)cm^3,P=0.007],DWI信号差异有统计学意义(60.87%比90.00%,P=0.04),MRI增强扫描动脉早期病灶强化方式差异有统计学意义(P<0.001)。动态增强病灶时间一信号强度曲线类型及强化后病灶形态、边缘比较,差异均无统计学意义(P>0.05)。结论乳腺X线摄影为重叠影像,腺体量多、腺体致密是造成假阴性结果的重要原因。乳腺癌X线假阴性病例的MRI表现具有一定的特征性。MRI可弥补X线摄影的不足,提高乳腺癌的检出率。
Purpose To analyze MRI features of false negative breast cancer detected by mammography. Materials and Methods Twenty-three patients （false negative group） with breast cancer confirmed by pathology but whose X-ray diagnosis was breast imaging reporting and data system （BI-RADS） 1 or 2 were retrospectively analyzed, and 30 cases （control group） diagnosed as BI-RADS 4C or 5 with X-ray in the same period were included. Patients in the two groups all received breast MRI within 1 week after mammogrphy and then MRI features of breast cancer in the two groups were compared. Results There was statistical difference regarding difference of gland types （P=0.04）. Difference of lesion average volume was of statistical significance [（3.51±0.12） cm^3 vs. （23.93±7.25） cm^3, P=0.007]. Difference of diffusion weighted imaging signal was of statistical significance （60.87% vs. 90.00%, P=0.04）. Difference of enhancement methods in scanning early-stage arterial lesions with enhanced CT was of statistical significance （P〈0.001）. There was no statistical significance in the difference of dynamic enhanced lesion time-signal intensity curve type and enhanced lesion morphology and margin （P〉0.05）. Conclusion Images from mammography are overlapped and glands quantities as well as gland density is important reasons for false negative. MRI imaging representations in cases with false negative breast cancer mammography are of certain characteristics and could be reasons in false negative diagnosis with breast mammography examination. MRI could make up insufficiency of mammography and enhance the detection rate of breast cancer.
作者
段淑英
杨学东
孙黎
张来运
DUAN Shuying;YANG Xuedong;SUN Li;ZHANG Laiyun(Department of Radiology,Guang＇anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053)
出处
《中国医学影像学杂志》
CSCD
北大核心
2018年第9期654-657,共4页
Chinese Journal of Medical Imaging
关键词
乳腺肿瘤
乳房X线摄影术
假阴性反应
磁共振成像
病理学
外科
Breast neoplasms
Mammography
False negative reactions
Magnetic resonance imaging
Pathology
surgical
