目的：探讨乳腺MRI常规序列及弥散加权成像（Diffusion weighted imaging，DWI）对不同类型黏液腺癌的诊断价值。方法：回顾性收集本院18例经手术病理证实的乳腺黏液腺癌患者，其中单纯型黏液腺癌12例，混合型黏液腺癌6例，比较分析两组不同类型乳腺黏液腺癌的MRI表现。结果：18例不同类型乳腺黏液腺癌MRI表现有所不同：①病灶边缘形态不同：75.0%（9/12）单纯型黏液腺癌表现为边缘光滑，66.7%（4/6）混合型黏液腺癌表现为毛刺状边缘；②T2WI信号不同：83.3%（10/12）单纯型黏液腺癌T2WI为高信号，83.3%（5/6）混合型黏液腺癌多表现为高低混杂信号；③表观弥散系数（Apparent diffusion coefficient，ADC）不同：单纯型黏液癌平均ADC值（（1.9±0.3）×10-3 mm2/s）高于混合型黏液癌（（1.1±0.2）×10-3 mm2/s）。各组比较差异均有统计学意义（P<0.05）。结论：不同病理学类型的乳腺黏液腺癌在MRI上具有不同的特征性表现，其病灶边缘、T2WI信号强度及ADC值均有不同。MRI是诊断黏液腺癌的有效影像方法，对鉴别单纯型黏液腺癌及混合型黏液腺癌具有重要价值。
Abstract
Objective: To retrospectively evaluate the diagnostic value of breast MRI in different types of mucinous adenocarcinoma of the breast. Methods: A total of 18 patients undergone surgery were retrospectively collected in our hospital, who were diagnosed with mucinous adenocarcinoma by pathology, including 12 mixed mucinous adenocarcinoma and 6 pure mucinous adenocarcinoma. MR features of two groups were compared. Results: The different MR features of the two groups including: ①Different boundary: 75.0%(9/12) pure mucinous adenocarcinoma had smooth edge, 66.7%(4/6) mixed mucinous adenocarcinoma had speculated edge. ②Different signal intensity on T2WI: 83.3%(10/12) pure mucinous adenocarcinoma were extremely high signal intensity, 83.3%(5/6) mixed mucinous adenocarcinoma were high-low mixed signal intensity. ③Different ADC value: the mean ADC value of pure mucinous adenocarcinoma ((1.9±0.3)×10-3 mm2/s) were higher than that of mixed mucinous adenocarcinoma((1.1±0.2)×10-3 mm2/s). All the results above were regarded as statistically significant(P<0.05). Conclusion: There are significant differences of pure mucinous adenocarcinoma and mixed mucinous adenocarcinoma on MRI in the boundary of tumor, T2 signal intensity and ADC value. MRI is an effective imaging method for diagnosis of mucinous breast carcinoma, and to identify pure mucinous adenocarcinoma and mixed mucinous adenocarcinoma.
关键词
乳腺肿瘤 /
腺癌 /
粘液 /
磁共振成像
Key words
Breast neoplasms /
Adenocarcinoma, mucinous /
Magnetic resonance imaging
中图分类号：
Ｒ737.9
Ｒ730.262
Ｒ445.2
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参考文献
[1]Reeves GK, Pirie K, Green G, et al. Reproductive factors and specific histological types of breast cancer: prospective study Meta-analysis[J]. Br J Cancer, 2009, 100(3): 538-544.
[2]Zhang L, Jia N, Han L, et al. Comparative analysis of imaging and pathology features of mucinous carcinoma of the breast[J]. Clin Breast Cancer, 2015, 15(2): e147-154.
[3]张建兴，蔡丽珊，宋光辉，等. 不同类型乳腺黏液腺癌彩色多普勒超声特征对比研究[J]. 中华医学超声杂志，2013，10（12）：979-983．
[4]崔春艳，张伶伍，尧泮，等. 乳腺黏液腺癌钼靶X线表现与病理相关性分析[J]. 影像诊断与介入放射学，2011，20（3）：225-228.
[5]Di Saverio S, Gutierrez J, Avisar E. A retrospective review with long term follow up of 11 400 cases of pure mucinous breast carcinoma[J]. Breast Cancer Res Treat, 2008, 111(3): 541-547.
[6]Bocker W. World Health Organization classification of tumors: pathology and genetics of tumors of the breast and female genital organs[M]. Lyon: I ABC Press, 2012: 49-50.
[7]刘佩芳，尹璐，牛昀，等． 乳腺黏液腺癌MRI表现特征及其与病理对照研究[J]． 中华放射学杂志，2009，43（5）：470-475．
[8]牛昀． 乳腺肿瘤病理诊断学[M]． 天津：天津科学技术出版社，2006：144-148．
[9]袁静萍，袁修学，夏小丽，等. 乳腺粘液癌临床病理特点分析[J]. 中华内分泌外科杂志，2010，4（1）：60-64.
[10]Bal A, Joshi K, Sharma S C, et al. Prognostic significance of micropapillary pattern in pure mucinous carcinoma of the breast[J]. Int J Surg Pathol, 2008, 16(3): 251-256.
[11]Paramo JC, Wilson C, Velarde D, et al. Pure mucinous carcinoma of the breast: is axillary staging necessary?[J]. Ann Surg Oncol, 2002, 9(2): 161-164.
[12]Okafuji T, Yabuuchi H, Sakai S, et al. MR imaging features of pure mucinous carcinoma of the breast[J]. Eur J Radiol, 2006, 60(3): 405-413.
[13]Hanagiri T, Ono K, Baba T, et al. Clinicopathologic characteristics of mucinous carcinoma of the breast [J]. Int Surg, 2010, 95(2): 126-129.
[14]Woodhams R, Kakita S, Hata H, et al. Diffusion-Weighted Imaging of Mucinous Carcinoma of the Breast: Evaluation of Apparent Diffusion Coefficient and Signal Intensity in Correlation With Histologic Findings[J]. AJR, 2009, 193(1): 260-266.
