Value of mammography combined with enhanced magnetic resonance imaging in diagnosing ductal carcinoma in situ
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摘要: 目的 探讨乳腺导管原位癌(DCIS)的特征性影像学表现以及钼靶X线摄影以及增强磁共振成像(MRI)联合诊断的优势。 方法 收集本院行手术治疗且术后病理证实为乳腺DCIS及DCIS伴微浸润的45例患者的影像资料,分析DCIS在钼靶X线和增强MRI上的特征性影像学表现,并评价钼靶X线联合增强MRI的诊断效能。 结果 钼靶X线可见钙化28例(28/45, 62.2%), 其中簇状钙化12例(12/28, 42.9%), 段样分布钙化13例(13/28, 46.4%), 区域分布钙化3例(3/28, 10.7%)。增强MRI可见非肿块样强化33例(33/45, 73.3%), 其中段样分布强化11例(11/33, 33.3%), 线样分布强化10例(10/33, 30.3%), 局灶性强化9例(9/33, 27.3%), 区域分布的强化3例(3/33, 9.1%)。非肿块样强化内部可见集群状强化18例(18/33, 54.5%), 不均匀强化13例(13/33, 39.4%), 均匀强化2例(2/33, 6.1%), 簇状环形强化21例(21/33, 63.6%)。钼靶X线摄影、增强MRI及两者联合诊断对DCIS诊断准确率分别为53.3%、71.1%、86.7%, 3种方法的诊断准确率比较差异有统计学意义(P<0.05)。 结论 乳腺钼靶X线上簇状或段样分布的钙化灶,增强MRI上线样或段样分布的非肿块样强化,内部呈集群样强化或簇状环形强化,是DCIS的特征性影像学表现。钼靶X线摄影与增强MRI的联合诊断可以优势互补,提高DCIS诊断的准确率。Abstract: Objective To investigate characteristic imaging manifestation of ductal carcinoma in situ(DCIS)and the advantages of mammography combined with enhanced magnetic resonance imaging(MRI)in diagnosing DCIS. Methods Imaging results of 45 patients undergoing surgery and confirmed as DCIS and DCIS with small invasive foci were retrospectively reviewed in our study. The imaging manifestations of DCIS in mammography and enhanced MRI were analyzed, and diagnostic efficacy of mammography combined with enhanced MRI in diagnosing DCIS was evaluated. Results Mammograms findings of DCIS showed calcification in 28 cases(28/45, 62.2%), including clustered calcification in 12 cases(12/28, 42.9%)and segmental calcification in 13 cases(13/28, 46.4%), and regional distribution calcification in 3 cases(3/28, 10.7%). Enhanced MRI findings showed that there were 33 cases(33/45, 73.3%)with non-mass enhancement, and the distribution patterns included segmental enhancement in 11 cases(11/33, 33.3%), linear enhancement in 10 cases(10/33, 30.3%), focal enhancement in 9 cases(9/33, 27.3%)and regional distribution enhancement in 3 cases(3/33, 9.1%). The internal enhancement patterns of non-mass enhancement included clumped pattern in 18 cases(18/33, 54.5%), heterogeneous enhancement in 13 case(13/33, 39.4%), homogeneous enhancement in 2 cases(2/33, 6.1%)and clustered ring enhancement in 21 cases(21/33, 63.6%). The accuracy rates of mammography, enhanced MRI and their combination in diagnosis of DCIS were 53.3%, 71.1% and 86.7%, and there were statistically - significant differences in accuracy rates(P<0.05). Conclusion Clustered or segmental calcification in mammograms, segmental or linear enhancement with clumped internal architecture and clustered ring enhancement in enhanced MRI are the characteristic imaging manifestations of DCIS. The combination of mammography and enhanced MRI could achieve mutual complementarity and improve the diagnostic accuracy of DCIS.
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陶秀丽, 李忱瑞, 李静, 等. 单纯乳腺导管内癌的3. 0T MR影像表现(附97例)分析[J]. 医学影像学杂志, 2013, 23(10): 1553-1557. 顾雅佳, 王玖华, 涂小予, 等. 乳腺导管原位癌的钼靶X线表现与病理对照研究[J]. 中华放射学杂志, 2002, 36(3): 240-244. 蔡斌, 汪湍, 李莉, 等. 浸润性导管癌与导管原位癌的钙化特点与组织病理学特征[J]. 中国医学影像技术, 2013, 29(1): 67-70. 李二妮, 胡满仓, 李静, 等. 乳腺X线摄影检出的恶性微钙化在MR上的影像表现[J]. 现代肿瘤医学, 2019, 27(15): 2732-2735. Kuhl C K, Schrading S, Bieling H B, et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study[J]. Lancet, 2007, 370(9586): 485-492.
Greenwood H I, Heller S L, Kim S, et al. Ductal carcinoma in situ of the breasts: review of MR imaging features[J]. Radiographics, 2013, 33(6): 1569-1588.
Yamada T, Mori N, Watanabe M, et al. Radiologic-Pathologic Correlation of Ductal Carcinoma in Situ[J]. Radiographics, 2010, 30(5): 1183-1198.
Rosen E L, Smith-Foley S A, DeMartini W B, et al. BI-RADS MRI enhancement characteristics of ductal carcinoma in situ[J]. Breast J, 2007, 13(6): 545-550.
Morakkabati-Spitz N, Leutner C, Schild H, et al. Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI[J]. Eur Radiol, 2005, 5(9): 2010-2017.
Raza S, Vallejo M, Chikarmane S A, et al. Pure ductal carcinoma in situ: a range of MRI features[J]. Am J Roentgenol, 2008, 191: 689-699.
Tozaki M, Igarashi T, Fukuda K. Breast MRI using the VIBE sequence: clustered ring enhancement in the differential diagnosis of lesions showing non-masslike enhancement[J]. Am J Roentgenol, 2006, 187(2): 313-321.
Lee S M, Nam K J, Choo K S, et al. Patterns of malignant non-mass enhancement on 3-T breast MRI help predictinvasiveness: using the BI-RADS lexicon fifth edition[J]. Acta Radiol, 2018, 59(11): 1292-1299.
Chikarmane S A, Michaels A Y, Giess C S. Revisiting Nonmass Enhancement in Breast MRI: Analysis of Outcomes and Follow-Up Using the Updated BI-RADS Atlas[J]. Am J Roentgenol, 2017, 209(5): 1178-1184.
张敏, 董光, 聂家秋, 等. 动态增强MRI及DWI对乳腺导管原位癌和腺病的诊断[J]. 临床放射学杂志, 2017, 36(12): 1759-1762. Rahbar H, Partridge S C, Demartini W B, et al. In vivo assessment of ductal carcinoma in situ grade: a model incorporating dynamic contrast-enhanced and diffusion-weighted breast MR imaging parameters[J]. Radiology, 2012, 263(2): 374-382.
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