乳腺葉狀腫瘤與單純型黏液癌的MRI征象及鑒別診斷
本文選題:乳腺腫瘤 + 葉狀腫瘤; 參考:《放射學(xué)實(shí)踐》2017年02期
【摘要】:目的:探討乳腺葉狀腫瘤(PT)和單純型黏液癌(PMBC)的MRI表現(xiàn)和鑒別診斷。方法:回顧性分析經(jīng)手術(shù)病理證實(shí)的16例PT和23例PMBC的臨床及MRI資料,包括發(fā)病年齡、MRI征象、Fischer評分結(jié)合BI-RADS分類、早期增強(qiáng)率(EER),對兩者的上述資料進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:PT的發(fā)病年齡比PMBC小(t=-2.189,P0.05);PT和PMBC在T1及T2信號特征、內(nèi)部強(qiáng)化特征、時間-信號強(qiáng)度曲線(TIC)類型上差異均具有統(tǒng)計學(xué)意義(P均0.05);PT和PMBC在病灶大小、形態(tài)、邊緣、低信號分隔、鄰近血管征象(AVS)、Fischer評分結(jié)合BI-RADS分類上均無統(tǒng)計學(xué)差異(P均0.05);PT的EER高于PMBC(P0.05),EER鑒別診斷PT和PMBC的受試者操作特征(ROC)曲線下面積為0.750,最佳界值為136.25%,診斷試驗(yàn)的敏感度為68.8%,特異度為81.8%,診斷符合率為76.3%。結(jié)論:雖然PT和PMBC的MRI表現(xiàn)多有重疊,但結(jié)合多個征象進(jìn)行綜合分析有助于兩者的鑒別診斷。
[Abstract]:Objective: to investigate the MRI findings and differential diagnosis of phyllodes tumor (PTT) and simple mucinous carcinoma (PMBC). Methods: the clinical and MRI data of 16 cases of PT and 23 cases of PMBC confirmed by operation and pathology were analyzed retrospectively, including the age of onset and the grade of Fischer and the classification of BI-RADS. The early enhancement rate was analyzed statistically. Results there were statistically significant differences in T1 and T2 signal characteristics, internal enhancement characteristics, time-signal intensity curve (TICI) types between PT and PMBC in the age of onset than those in PMBC. There were significant differences between PT and PMBC in the size, shape, edge and low signal intensity of the lesions. There was no statistical difference between the BI-RADS classification and the Fischer score of adjacent vascular signs. The area under the curve of EER in the differential diagnosis of PT and PMBC was 0.750, the optimal threshold was 136.25, the sensitivity of diagnostic test was 68.8%, the area under the curve of differential diagnosis PT and PMBC was 0.750, and the sensitivity of diagnostic test was 68.8%. The heterogeneity was 81.8 and the diagnostic coincidence rate was 76.3. Conclusion: although the MRI findings of PT and PMBC are overlapped, comprehensive analysis of multiple signs is helpful for differential diagnosis of PT and PMBC.
【作者單位】: 中國醫(yī)科大學(xué)腫瘤醫(yī)院、遼寧省腫瘤醫(yī)院醫(yī)學(xué)影像科;
【分類號】:R737.9;R445.2
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