乳腺叶状肿瘤的MRI表现与病理学分级的相关性研究

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英文篇名：MRI Features and Correlation with Pathologic Findings in Breast Phyllodes Tumors 作者：徐茂林 ; 谢东 ; 李芳 ; 刘玉林 ; 唐琪 ; 陈宪 英文作者：XU Maolin;XIE Dong;LI Fang;Department of Radiology,Hubei Provincial Cancer Hospital; 关键词：乳腺 ; 叶状肿瘤 ; 磁共振成像 ; 形态和功能学 ; 病理学 英文关键词：Breast;;Phyllodes tumor;;Magnetic resonance imaging;;Morphological and functional;;Pathology 中文刊名：LCFS 英文刊名：Journal of Clinical Radiology 机构：湖北省肿瘤医院放射科;广西医科大学附属肿瘤医院影像诊断中心;湖北省肿瘤医院超声科; 出版日期：2019-07-20 出版单位：临床放射学杂志 年：2019 期：v.38;No.348 基金：广西科学研究与技术开发计划资助项目(桂科攻14124004-1-11) 语种：中文; 页：LCFS201907012 页数：5 CN：07 ISSN：42-1187/R 分类号：52-56

摘要

目的探讨乳腺叶状肿瘤(PT)的MRI形态及功能学表现及其与病理学特征的相关性。方法回顾性分析52例经手术病理证实的乳腺叶状肿瘤的临床及MRI资料,观察病灶的形态、边界、最大径、T_2WI内部信号、内部分隔、增强信号、ADC值及时间-信号强度曲线类型,并与其病理结果进行对照分析。结果 52个PT病灶中,组织学分级为良性、交界性、恶性者分别为16例(30. 8%),22例(42. 3%),14例(26. 9%);不规则形44例(84. 6%),类圆形8例(15. 4%);边界清晰者38例(73. 1%),模糊者14例(26. 9%);病灶最大径为1. 91～14. 73 cm; T_2WI内部信号均匀者4例(7. 7%),不均匀者48例(92. 3%); T_2WI内部有低信号分隔者34例(65. 4%),无分隔者18例(34. 6%);增强信号均匀者12例,不均匀者40例; ADC值范围为(0. 92～1. 72)×10~(-3)mm~2/s;时间-信号强度曲线类型中,22例呈Ⅰ型(42. 3%),22例呈Ⅱ型(42. 3%),8例呈Ⅲ型(15. 4%)。良性、交界性及恶性组的病灶ADC值、T_2WI低信号分隔差异均有统计学意义(P值均<0. 05);病灶ADC值、T_2WI低信号分隔与组织学分级具有一定的相关性(r=-0. 699、0. 484,P值均<0. 05)。而病灶的其余征象在不同组织学分级组间均无明显差异(P值均>0. 05)。结论乳腺PT的MRI表现具有一定的特征性,病灶ADC值、T_2WI低信号分隔与组织学分级有一定的相关性。
        Objective To evaluate the morphological and functional features of MRI in breast phyllodes tumors( PT)and the correlation between its MRI performance and pathologic findings. Methods Clinical and MRI features were retrospectively reviewed in 52 patients with breast phyllodes tumors( PT) proved by pathology. The MRI findings of lesions contained the lesions,morphology,edge,size,internal signal and lower signal septation in T_2WI,internal signal of enhancement,apparent diffusion coefficient( ADC) value and the time signal-intensity curves( TICs),which were correlated with the pathological result. Results The histologic findings were benign,borderline and maglignant PT in 30. 8%( 16/52),42. 3%( 22/52) and 26. 9%( 14/52) of lesions,respectively. 84. 6%( 44/52) cases were irregular in shape,while the other 15. 4%( 8/52) were oval. 73. 1%( 38/52) cases showed smooth edge,while the other 26. 9%( 14/52) had unclear edge. Tumor size ranged from 1. 91 to 14. 73 cm. 7. 7%( 4/52) cases appeared as homogeneous signal in T_2WI,while 92. 3%( 48/52) were heterogeneous. 65. 4%( 34/52) cases had lower signal septation in lesions,while the other 34. 6%( 18/52) had no septation. 12 cases had homogeneous enhancement,while the other 40 cases was displayed as heterogeneous enhancement. ADC values of PT ranged from 0. 92 × 10~(-3) mm~2/s to 1. 72 × 10~(-3) mm~2/s. Among all tumors' TICs,22 showed I type,22 showed II type,8 showed III type. As to all cases,ADC value and lower signal septation in T_2WI were statistically different( all P < 0. 05). ADC value and lower signal septation in T_2WI correlated with the histological grades( r =-0. 699、0. 484,all P < 0. 05). The other features of MRI among different histological grade of PT all had no significant difference( all P > 0. 05). Conclusion The findings of PT on MRI may have some characteristics,while lesions' ADC value and Lower signal septation in T_2WI have certain correlation with the histological grade of breast PT.

引文

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