磁共振成像在乳腺癌保乳术前评价中的应用

摘要

Objective To evaluate the influence of preoperative MRI on tumor-positive rate of resection margins in breast cancer patients eligible for breast-conserving surgery.Methods Study group consisted of 64 consecutive patients with breast cancer eligible for breast-conserving surgery,while 73 cases as history control group.For the two groups,a first plan for breast-conserving surgery was made on the basis of conventional imaging and clinical evaluation.Study group underwent preoperative breast MRI and re-evalu-ated before final surgical plan was made.Rates of tumor-positive resection margins were compared between the 2 groups.Surgical plan alteration was recorded in the study group.Results Study group had lower rate of tumor-positive resection margin compared with control group (9.6% vs 24.7%,P =0.04).Furthermore,18.8% of study group altered the finial surgical plan to mastectomy after breast MRI.Conclusion Preoperative breast MRI can more acurately evaluate the extent of breast cancer,therefore decrease rate of tumor-positive resection margin in breast cancer patients eligible for breast-conserving surgery.%目的：评价术前磁共振成像(MRI)对乳腺癌保乳术切缘阳性率的影响。方法收集乳腺癌患者64例为研究组，历史对照组73例乳腺癌患者，所有患者经常规检查及评估后均适合行保乳术。研究组患者术前行乳腺 MRI 检查，经评估后确定最终的手术计划。历史对照组未行 MRI 检查。比较2组患者的切缘阳性率差异，记录研究组的手术变更率。结果与对照组相比，研究组保乳术中的切缘阳性率降低(9.6% vs 24.7%；P =0.04)。术前 MRI 使18.8%的患者改变手术计划而行乳房全切术。结论术前乳腺 MRI 检查能更准确评估乳腺癌病灶的范围，从而有助于降低保乳术患者的术中切缘阳性率。