摘要
目的探讨不同病理分级的乳腺叶状肿瘤(Breast Phyllodes Tumors,BPT)MRI影像表现的特征。方法回顾性分析2018年2月——2022年6月本院收治的经手术后病理证实BPT的33例患者的MRI表现,按ACR乳腺影像报告和数据系统(BI-RADS),分析不同病理分级的BPT患者病灶的MRI影像学表现:形态、边界、大小,信号特点、强化方式、时间-信号强度曲线TIC(Time-signal Intensity Curve)以及表观扩散系数ADC(Apparent Diffusion Coefficient),通过列联表χ^(2)检验和单因素方差分析进行比较分析不同病理分级的BPT病灶MRI影像特征及其相关性。结果33例BPT中,良性21例(63.6%),交界性7例(21.2%),恶性5例(15.2%)。病灶边界清晰者25例(75.8%),模糊者8例(24.2%);T2WI均匀高信号者10例(30.3%),不均匀高信号者23例(69.7%);病灶内无囊变者25例(75.8%),有囊变者8例(24.2%);增强后均匀强化者15例(45.5%),不均匀强化者18例(54.5%);TIC曲线类型中Ⅰ型7例(21.2%),Ⅱ型21例(63.6%),Ⅲ型5例(15.2%);良性、交界性及恶性组的病灶在MRI图像上,边界、T2WI信号特征、病灶有无囊变,动态增强后强化方式,TIC曲线类型及病灶的ADC值组间差异有统计意义(P=0.007、0.017、0.007、0.005、0.007、0.009);病灶ADC值组织学分级具有一定的相关性(r=-0.422、P=0.014)。而病灶的其余征象在不同组织学分级组间均无明显差异(P均>0.05)。结论BPT的MRI表现可提示病灶的术前诊断及病理分级,对指导临床手术及对患者预后评估有重要意义。
Objective To investigate the MRI features of phyllode tumor of the breast(PTB)with different pathological grades.Methods The MRI findings of 33 patients with PBT confirmed by pathology after surgery in Yijishan hospital of Wannan Medical College were retrospectively analyzed.According to ACR breast imaging reporting and data system(BI-RADS),the MRI imaging findings:shape,boundary,size,signal characteristics,enhancement mode,time-signal intensity curve(TIC)and apparent diffusion coefficient(ADC)of PBT lesions with different pathological grades were analyzed.The MRI features and correlation of PBT lesions with different pathological grades were compared and analyzed by using chi-square test of contingency table and one-way analysis of variance.Results Among the 33 cases of PTB,20 cases(60.6%)were benign,7 cases(21.2%)were borderline,and 5 cases(15.2%)were malignant.The lesion boundary was clear in 25 cases(75.8%)and blurred in 8 cases(24.2%).There were 10 cases(30.3%)of homogeneous hyper-intensity on T2WI and 23 cases(69.7%)of heterogeneous hyper-intensity.There were 25 cases(75.8%)without cystic lesions and 8 cases(24.2%)with cystic lesions.After enhancement,15 cases(45.5%)had uniform enhancement and 18 cases(54.5%)had uneven enhancement.Among the TIC curve types,7 cases(21.2%)were typeⅠ,21 cases(63.6%)were typeⅡ,5 cases(15.2%)were typeⅢ.In MRI images among the benign,borderline and malignant groups,there were statistically significant differences in boundary,T2WI signal characteristics,cystic lesion,dynamic enhancement mode,TIC curve type and ADC value of lesions(P=0.007,0.017,0.007,0.005,0.007,0.009).There was a certain correlation between ADC value and histological grade(r=-0.422,P=0.014).However,there were no significant differences in the other signs of the lesions between different histological grades(all P>0.05).Conclusions The MRI findings of PTB could indicate the preoperative diagnosis and pathological grade of the lesions,which is of great significance for guiding clinical operation and evaluating
作者
徐静雅
吴树剑
翟建
Xu Jingya;Wu Shujian;Zhai Jian(Imaging center,Yijishan hospital,Wannan Medical College,Wuhu,Anhui,241001,China)
出处
《齐齐哈尔医学院学报》
2022年第21期2034-2037,共4页
Journal of Qiqihar Medical University
关键词
乳腺叶状肿瘤
磁共振成像
病理学
Phyllode tumor of the breast
Magnetic resonance imaging
Pathology
