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乳腺复杂型纤维腺瘤MRI表现特征 被引量:6

Magnetic resonance imaging features of breast complex fibroadenoma
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摘要 目的探讨乳腺复杂型纤维腺瘤(CFA)的MRI表现特征。方法回顾性分析行乳腺MRI检查并经手术病理证实的27例CFA病人的临床、影像及病理资料。系统性分析CFA MRI平扫以及动态增强MRI(DCEMRI)表现特征,并于DCE-MRI及扩散加权成像(DWI)上分别测量病变的时间-信号强度曲线(TIC)类型及表观扩散系数(ADC)值。结果病理上,CFA伴囊性增生者共23例(85.2%,23/27),CFA伴有导管上皮不典型增生有15例(55.6%,15/27)。27例CFA在MRI上均表现为肿块型病变,22例(81.5%,22/27)呈类圆形或卵圆形,25例(92.6%,25/27)边缘毛糙,但缺乏典型“毛刺”恶性特征。MRI平扫显示,17例(63.0%,17/27)CFA于T1WI上呈稍低信号,25例(92.6%,25/27)于抑脂T2WI上呈较高信号。动态增强扫描后27例CFA均呈明显强化,其中17例(63.0%,17/27)于早期时相呈不均匀强化,随时间延迟病灶内部强化趋于均匀。TIC类型表现为Ⅲ型者15例(55.6%,15/27),Ⅱ型者3例(11.1%,3/27),Ⅰ型者9例(33.3%,9/27)。DWI上26例(96.3%,26/27)CFA呈较高信号,仅1例(3.7%,1/27)呈较低信号。b值为500 s/mm^2及1000 s/mm^2时,病变平均ADC值分别为(1.36±0.19)×10^-3 mm^2/s及(1.27±0.21)×10^-3 mm^2/s。结论CFA MRI表现与乳腺癌类似,但其边缘通常缺乏典型“毛刺”的恶性征象,于动态增强早期时相呈不均匀强化并随时间延迟CFA内部强化趋于均匀,该表现具有一定特征性。 Objective To analyze the MRI features of breast complex fibroadenomas (CFA).Methods The clinical,imaging and pathological data of 27 patients with CFA confirmed by pathology were analyzed retrospectively.The characteristics of plain and dynamic contrast enhanced MRI (DCE-MRI) were analyzed systemically.The time-signal intensity curve (TIC)type and apparent diffusion coefficient (ADC) value of lesions were measured on DCE-MRI and diffusion weighted imaging(DWI),respectively.Results Pathologically,there were 23 cases (85.2%,23/27) of CFA with cystic hyperplasia of CFA,and 15 cases (55.6%,15/27) with atypical hyperplasia.All of the CFA manifested as masses on MRI.In terms of morphological manifestations,81.5%(22/27) of lesions were oval or round-shaped,92.6%(25/27) of lesions’margin was irregular but not typically spiculated.On the T1WI,63.0%(17/27) of lesions showed slightly lower signals,and on the FS-T2WI,92.6%(25/27)of lesions showed slightly hyperintensity.On the dynamic enhancement scans,CFA showed obvious enhancement in all 27cases,of which 17 cases (63.0%,17/27) showed heterogeneous enhancement in the early phase and their internal enhancement tended to be homogeneous with time delaying in dynamic observation.In terms of TIC types,15 cases (55.6%,15/27) CFA showed type III,3 cases (11.1%,3/27) showed type Ⅱ,and 9 cases (33.3%,9/27) showed type Ⅰ.On DWI,26 (96.3%,26/27)cases showed high signal,and only 1 (3.7%,1/27) case showed low signal.When the b value was 500 s/mm2 and 1 000 s/mm2,the average ADC values were (1.36±0.19)×10-3mm2/s and (1.27±0.21)×10-3mm2/s,respectively.Conclusion The MRI characteristics of the CFA are partly similar to breast cancer,but the margin of the CFA is not typically spiculated,and the internal enhancement pattern of the lesions is heterogeneous in the early phase,then tends to be homogeneous with time delaying under dynamic observation,which has certain characteristics.
作者 赵梦然 路红 刘君君 马文娟 季宇 刘佩芳 ZHAO Mengran;LU Hong;LIU Junjun;MA Wenjuan;JI Yu;LIU Peifang(Department of Breast Imaging,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin’s Clinical Research Center for Cancer,Key Laboratory of Breast Cancer Prevention and Therapy,Tianjin Medical University,Ministry of Education,Tianjin 300060,China)
出处 《国际医学放射学杂志》 北大核心 2020年第6期721-725,共5页 International Journal of Medical Radiology
基金 国家自然科学基金(81801781)。
关键词 乳腺肿瘤 纤维腺瘤 复杂型纤维腺瘤 磁共振成像 诊断 Breast neoplasms Fibroadenomas Complex fibroadenomas Magnetic resonance imaging Diagnosis
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