乳腺癌术后瘢痕组织的MRI表现

摘要

目的 探讨乳腺癌术后瘢痕组织的动态增强及扩散加权成像的磁共振成像(MRI)表现.方法 回顾性分析2013年6月至2017年7月北京中医药大学第三附属医院就诊的25例乳癌保乳术后瘢痕的动态对比增强及扩散加权成像的MRI表现及病理资料.分析乳腺癌术后瘢痕组织的动态增强及扩散加权成像的特点,计算其时间-信号强度曲线(TIC)、早期强化率(ECR)和ADC值(b=0.800 s/mm2).结果 25例乳癌保乳术后形成瘢痕组织中5例瘢痕组织呈小结节样,20例呈斑片状、条索样;T1加权成像呈低信号,T2加权成像7例呈稍低信号,18例为略高信号.15例呈斑片状、结节样轻度强化,10例瘢痕组织无明确强化.15例强化的瘢痕组织中,12例TIC为Ⅰ型,2例TIC为Ⅱ型,1例TIC为Ⅲ型,其ECR为(75.25±16.30)％,扩散加权成像呈等信号,ADC值为(1.17±0.23)×10-3 mm2/s.结论 MRI能清晰显示乳腺瘢痕组织的形态特征、累及范围、所在部位,动态对比增强-MRI半定量参数及ADC值能为其诊断及鉴别诊断提供辅助诊断依据.%Objective To study magnetic resonance imaging ( MRI) findings of scar tissue developed after the breast conserving treatment .Methods In this retrospective study ,25 cases of breast cancer confirmed by histological results were enrolled.All of the cases received breast conserving treatment .Dynamic contrast enhanced (DCE)-MRI and diffusion weigh-ted imaging(DWI)-MRI were performed in all cases,the type of time-signal intensity curve (TIC),early contrast rate (ECR) and ADC value(b=0.800 s/mm2) were analysed.Results Scar tissue in 5 cases showed small nodules,and 20 cases were patchy and cord like .On T1WI,the scar tissues appeared hypointense and isointense .On T2WI, the scar tissues appeared hyperintense in 18 cases,slightly hypointense in 7 cases.The lesions displayed slightly to moderate contrast enhan cement in 15 patients and no enhancement in 10 patients.The ECR was 75.25％,and the ADC was (1.17 ±0.23) × 10 -3 mm2/s.The patterns of TIC were type Ⅰin 12 cases, type Ⅱ in 2 cases,type Ⅲ in 1 case.Conclusion MRI can clearly display the location , morphology , extent and margin of mammary scar tissues .DCE-MR and DWI-MR can provide assistant quantitative features for diagnosis of mammary scar tissues .