| 崔晓琳,刘学静,张洁,杨正汉.动态增强MRI诊断无钙化乳腺导管原位癌[J].中国医学影像技术,2021,37(3):391~395 |
| 动态增强MRI诊断无钙化乳腺导管原位癌 |
| Dynamic contrast-enhanced MRI in diagnosis of non-calcified ductal carcinoma in situ |
| 投稿时间：2020-03-03 修订日期：2020-06-23 |
| DOI：10.13929/j.issn.1003-3289.2021.03.019 |
| 中文关键词: 癌,导管,乳腺 原位癌 钙质沉着症 磁共振成像 乳房X线摄影术 |
| 英文关键词:carcinoma, ductal, breast carcinoma in situ calcinosis magnetic resonance imaging mammography |
| 基金项目: |
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| 摘要点击次数: 2498 |
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| 中文摘要: |
| 目的 探讨动态增强MRI诊断无钙化DCIS的价值。方法 回顾性分析129例接受乳腺X线摄影及MR检查并经手术病理证实的DCIS患者，根据X线摄影判定病灶是否存在钙化；比较有、无钙化DCIS病灶形态、早期强化、延迟强化方式、核分级及免疫组织化学指标差异。结果 133个DSIC病灶，48个无钙化，85个有钙化。MRI对无钙化DCIS的敏感度（48/48，100%）高于X线摄影（26/48，54.17%，χ2=28.54，P<0.01）。有、无钙化DCIS动态增强MRI早期强化及核分级差异均有统计学意义（χ2=6.41、6.79，P均<0.05），而病灶形态、延迟强化方式及ER、PR、HER-2表达差异均无统计学意义（P均>0.05）。钙化DSIC中，19个呈肿块样、65个非肿块样强化，其延迟强化方式差异存在统计学意义（χ2=6.34，P=0.04）。无钙化DCIS中，12个呈肿块样强化、36个呈非肿块样强化，其早期强化及延迟强化方式差异均无统计学意义（P均>0.05）。结论 MRI对无钙化DCIS的敏感度高于乳腺X线摄影；无钙化DCIS多为非高核级，动态增强MRI早期迅速强化。 |
| 英文摘要: |
| Objective To explore the value of dynamic contrast-enhanced MRI in diagnosis of non-calcified ductal carcinoma in situ (DCIS). Methods Data of 129 patients who underwent mammography and breast MRI and confirmed DCIS by pathology were retrospectively analyzed. Whether there were calcifications in the lesions or not were determined according to mammography. The morphology, early enhancement, delayed enhancement mode, nuclear grade and immunohistochemical indices were compared between lesions with or without calcification. Results Totally 133 DSIC lesions were included, 85 with and 48 without calcifications. The sensitivity of MRI (48/48, 100%) was lower than that mammography (26/48, 54.17%) for non-calcified DCIS (χ2=28.54, P<0.01). There were significant differences of early enhancement and nuclear grading between calcified DCIS and non-calcified DCIS (χ2=6.41, 6.79, both P<0.05), while no significant difference of lesion's morphology, delayed enhancement mode nor expression of ER, PR and HER-2 were found (all P>0.05). Among calcified DSIC, there were 19 mass-like enhancement and 65 non-mass-like enhancement, respectively, and statistical difference of delayed enhancement was found (χ2=6.34, P=0.04). Among non-calcified DCIS, there were 12 mass-like enhancement and 36 non-mass-like enhancement Lesions, t no significant difference of early nor delayed enhancement was found (both P>0.05). Conclusion The sensitivity of MRI for DCIS without calcification was higher than that of mammography. Non-high nuclear grade and early rapid enhancement were relative common in DCIS without calcification. |
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