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目的:探讨乳腺专用磁共振诊断导管内乳头状瘤的应用价值。方法:收集我院经手术病理证实的31例乳腺导管内孤立/多发乳头状瘤病例进行回顾性分析。所有病人术前均行乳腺X线、超声检查及AURORA乳腺专用磁共振平扫及动态增强扫描。参照乳腺影像报告和数据系统(BI-RADS),评价其病灶的形态学(包括病灶大小、形状、部位、边缘、多形性及与导管的关系)、动态增强扫描的强化模式及其他相关的特征,并与X线、超声检查相对照。结果:31例病人孤立导管内乳头状瘤23例,多发导管乳头状瘤8例。MRI共检出30个病灶,其中2例导管内乳头状瘤MRI为阴性,1例双侧多发导管乳头状瘤MRI检出双侧病灶。其MRI形态学表现最多见是沿导管分布多发小结节样或环形强化(38.7%),其次为乳晕后区孤立或多发结节样强化(22.6%)及乳晕后方导管样、线状、分支样强化(12.9%),伴或不伴导管扩张,MRI增强信号-时间曲线以平台型和流出型为主,具有一定的特征性。部分(4例)表现为类似恶性肿瘤的MRI征象(12.9%),难以与恶性肿瘤区分。结论:乳腺专用MRI检查对检出导管内乳头状瘤(病)具有较大的优势,能为临床手术治疗提供准确定位,具有较好的应用价值。
Objective: To investigate the value of breast magnetic resonance imaging in the diagnosis of intraductal papilloma. Methods: A retrospective analysis was performed on 31 cases of isolated / multiple papilloma in the breast duct confirmed by surgery and pathology in our hospital. All patients underwent preoperative breast X-ray, ultrasound and AURORA breast MRI and dynamic contrast-enhanced scan. According to the Breast Imaging Report and Data System (BI-RADS), the morphological features of lesion (including lesion size, shape, location, margin, pleomorphism and the relationship with the catheter), enhancement mode of dynamic contrast-enhanced scanning and other related Characteristics, and with X-ray, ultrasound contrast. Results: Twenty-three cases of isolated ductal papilloma were isolated from 31 patients and 8 were multiple ductal papillomas. MRI detected 30 lesions, of which 2 cases of intraductal papilloma MRI was negative, 1 case of bilateral multiple ductal papilloma MRI detection of bilateral lesions. The most common MRI findings were multiple nodular or annular enhancement along the ductal distribution (38.7%), followed by isolated or multiple nodular enhancement (22.6%) in the posterior region of the areola and posterior areolactoid, linear, branched (12.9%) with or without catheter dilatation. MRI-enhanced signal-time curves were mainly platform type and outflow type, with certain characteristics. Some (4 cases) showed similar malignant MRI signs (12.9%), difficult to distinguish with malignant tumors. Conclusion: The special MRI examination of mammary gland has a great advantage in detection of intraductal papilloma (disease), which can provide accurate positioning for clinical surgical treatment and has good application value.