摘要
目的探讨MRI在鉴别乳腺单纯型黏液癌与T_(2)高信号纤维腺瘤的价值。方法选取23例单纯型黏液癌和T_(2)高信号纤维腺瘤(31例),对比分析MRI特征差异。结果两组在年龄、形态、T_(1)高信号、平均ADC值、延迟强化方式、T_(2)低信号分隔、T_(2)低信号分隔强化、TIC曲线类型差异有统计学意义(P<0.05)。单纯型黏液癌发病年龄多大于40岁(22/23),形态多样,而纤维腺瘤中位年龄37岁,其中半数以上小于40岁(18/31),形态上呈圆形、卵圆形及分叶状;增强延迟期单纯型黏液癌体积较大,病灶呈岛状强化(6/23),较小病灶表现为环形或蜂窝状强化(11/23)、不均质实性强化(5/23),且绝大多数病灶内部存在无强化区,而纤维腺瘤多为均质(11/31)或不均质(19/31)实性强化;单纯型黏液癌T_(2)低信号分隔,在黏液成分较多时可见分隔延迟强化,黏液较少时低信号分隔与肿块同步强化、分隔消失,而纤维腺瘤T_(2)低信号分隔无强化;单纯型黏液癌平均ADC值显著高于纤维腺瘤。两组患者在大小(最大径)、边界等方面差异无统计学意义。结论乳腺单纯型黏液癌与T_(2)高信号纤维腺瘤存在较多差异特征,MRI增强扫描能进行有效鉴别。
Objective To investigate the value of MR in differentiating simple mucinous carcinoma of the breast from T_(2) hyperintense fibroadenoma.Methods Simple mucinous carcinoma(23 cases)and T_(2) high signal fibroadenoma(31 cases),and the differences in MR imaging characteristics were compared and analyzed.Results There were significant differences in age,morphology,T_(1) hyperintensity,average ADC value,delayed enhancement pattern,T_(2) hypointense separation,T_(2) hypointense separation enhancement,and TIC curve type between the two groups(P<0.05).Simplex mucinous carcinomas were mostly older than 40 years old(22/23)and had various shapes,while the median age of fibroadenomas was 37 years old,and more than half of them were younger than 40 years old(18/31),with round and oval shapes,and lobulated;enhancement-delayed simple mucinous carcinoma showed island-like enhancement in larger lesions(6/23),small lesions showed annular or honeycomb enhancement(11/23),and heterogeneous solid enhancement(5/23),and most of the lesions have non-enhanced areas,while fibroadenomas were mostly homogeneous(11/31)or heterogeneous(19/31)with solid enhancement;simple mucinous carcinoma T_(2) low signal separation.Delayed enhancement of the septum was seen when the mucinous component was high.When the mucinous component was low,the hypointense septum enhanced synchronously with the mass,and the septum disappeared,while the T_(2) hypointense septum of fibroadenoma showed no enhancement.The average ADC value of simple mucinous carcinoma was significantly higher than that of fibroadenoma.There was no statistical difference in the size(maximum diameter)and border between the two groups.Conclusion Simple mucinous carcinoma of the breast and T_(2) high signal fibroadenoma have many different characteristics,and enhanced MRI scan can be used for effective identification.
作者
杜亮
崔凤
周长玉
许茂盛
DU Liang;CUI Feng;ZHOU Changyu;XU Maosheng(Department of Radiology,The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310001,China;Department of Radiology,Hangzhou Hospital of Traditional Chinese Medicine,Affiliated to Zhejiang University of Traditional Chinese Medicine,Hangzhou 310007,China)
出处
《医学影像学杂志》
2022年第11期1918-1922,共5页
Journal of Medical Imaging
基金
浙江省杭州市医药卫生科研项目(编号:A20220800)。
关键词
乳腺黏液癌
纤维腺瘤
磁共振成像
鉴别诊断
Breast mucinous carcinoma
Fibroadenoma
Magnetic resonance imaging
Differential diagnosis
