Objective To investigate the imaging manifestations of breast phyllodes tumor on mammography, sonogram and MRI,based on BI-RADS. Methods Eighteen patients with twenty breast phyllodes tumors,proven by pathology, were collected from 2004 to 2011, including 6 benign, 5 boundary and 7 malignant tumors. 13,13 and 4 patients underwent mammography, sonograms and MRI examination,respectively. The tumors were multiple in unilateral breast in one patient and the others were single. According to BI-RADS lexicons, the imaging manifestations were retrospectively analyzed with gross and histological pathology as comparison. Results No matter benign,boundary or malignant phyllode tumors, they presented with the following imaging features:lobulated shape except 1 with focal asymmetry and 2 with oval shape,clear margin,abundant vascularization,homogeneous density/echo/signal intensity for tumor less than 5 cm (except 1 malignant tumor) , heterogeneity for tumor larger than 5 cm due to cystic or necrotic areas. No calcifications were seen. No signs of skin invasion and lymph node metastasis were noted. At MR imaging,the lesions were hyperin-tense on DWI,type III of density-time curve on dynamic contrast-enhanced images and choline peak presented on MRS. Conclusion BI-RADS is beneficial to analyse the imaging manifestations of breast phyllodes tumors comprehensively.%目的 应用乳腺影像报告和数据系统(BI-RADS)探讨乳腺叶状肿瘤的X线、超声及MRI表现,以期提高对该病的影像诊断能力.方法 收集2004-2011年经手术病理证实的乳腺叶状肿瘤18例(20个病灶),其中良性6例,交界性5例,恶性7例.13例行乳腺X线摄影检查,13例做乳腺超声检查,4例行乳腺MRI检查.1例患者为单侧乳腺多发(3个)肿瘤,余17例为单发.按照BI-RADS术语,回顾性分析其影像表现及病变分类,并与大体及镜下病理表现对照.结果 无论良性、交界性还是恶性,影像表现为:除1例于X线摄影表现为局部致密及2例于超声表现为椭圆形,余肿块均为分叶状;边界清楚;＜5 cm肿块除1例回声不均匀,余回声(或信号)均匀,而＞5 cm者因囊变易回声(或信号)不均匀;血供丰富;未见钙化;未侵犯乳头及皮肤;未见腋窝淋巴结转移.交界性及恶性者MRI动态增强曲线为III型,扩散加权成像表现为高信号,波谱见胆碱峰.BI-RADS病变分类多为4类.结论 应用BI-RADS有利于乳腺叶状肿瘤影像结果的综合比较.
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