目的：探讨3.0T MRI对HER-2阴性与HER-2过表达型肿块型乳腺浸润性导管癌的诊断价值。方法：回顾性分析2016年8月—2017年10月无锡市第二人民医院收治的79例经手术或活检病理证实为肿块型乳腺浸润性导管癌患者的资料，年龄25~73岁，所有患者术前均接受3.0T MRI检查。术前利用扩散加权成像及动态增强技术对病灶图像及各项参数进行测量及分析，且行统计学比较。结果：本组79例肿块型乳腺浸润性导管癌患者中，HER-2阴性者45例，HER-2过表达型者34例。HER-2阴性与HER-2过表达型两组患者年龄、肿块大小、扩散加权成像DWI信号、ADC值及时间-信号曲线间比较无统计学意义。两组肿块形态、肿块边缘、强化方式间比较有统计学意义。HER-2阴性乳腺浸润性导管癌肿块形态倾向于圆形或卵圆形，边缘相对清楚，增强扫描呈环形强化及均匀强化；HER-2过表达型肿块形态倾向于不规则形，肿块边缘倾向于不规则或者毛刺状改变，增强扫描肿块多表现为不均匀强化。结论：3.0T MRI部分表现特征（病灶形态、边缘、强化方式）对鉴别HER-2阴性及HER-2过表达型乳腺癌具有一定的诊断价值，从而有利于治疗计划与手术方案的选择与制定。
Abstract
Objective: To investigate the diagnostic value of 3.0T MRI in HER-2 negative and HER-2 overexpression subtype of mass-like breast invasive ductal cancer. Methods: Retrospective analysis of 79 women in Wuxi No.2 People’s Hospital confirmed breast invasive ductal cancer masses histopathologically was performed between August 2016 and October 2017, aged from 25 years to 73 years, all the patients received 3.0T MR scan. Preoperative diffusion weighted imaging and dynamic contrast-enhanced MR were acquired, we measured and analyzed the MRI imaging and parameters of the masses and compared the statistics. Results: All of 79 patients with breast invasive ductal cancer masses were clearly shown by MR images. There were 45 patients with HER-2 negative and 34 patients with HER-2 overexpression. There were no statistically significant difference among age, the tumor size, the signal of DWI, ADC value and the time-intensity curve between HER-2 negative and overexpression groups in 3.0T MRI. Compared with the shape, margin, the way of enhancement and of the HER-2 negative and HER-2 overexpression breast cancer, the distinction has statistically significant. The masses in HER-2 negative group tended to show as round or oval, clear margin, ring and homogeneous enhancement. The masses in HER-2 overexpression group tended to show as irregular shape, irregular or spiculate margin and inhomogeneous enhancement. Conclusions: 3.0T MRI partial features(the shape, margin, the way of enhancement) were useful for the prediction and diagnosis of HER-2 negative and HER-2 overexpression breast cancer, and to select and formulate an optimal treatment plan for patients with different types of breast cancer．
关键词
癌 /
导管 /
乳腺；磁共振成像
Key words
Carcinoma, ductal, berast /
Magnetic resonance imaging
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参考文献
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基金
无锡市科技成果与适宜技术推广项目（T201744）。
