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目的探讨动态增强MRI对早期乳腺癌的诊断价值。方法分析20例早期乳腺癌动态增强MRI资料。其中,导管内乳头状癌2例,导管原位癌4例,导管原位癌伴微浸润性12例,小叶原位癌2例。总结早期乳腺癌特征性MRI表现。结果 (1)病灶增强MRI形态特征:局灶性强化2例;导管样及段样强化8例;肿块状强化10例,其中的9例肿块边缘为毛刺及不规则,1例边缘光滑;边缘强化7例,其中的2例均匀中心强化,1例分隔强化。乳腺影像报告和数据系统(BI-RADS)分级:1级1例,3级2例,其余为4级或5级。(2)X线检查结果:阴性3例,微小簇状钙化5例,线样钙化2例,肿块6例,结构扭曲2例,斑片阴影2例。BI-RADS分级:1级3例,2级1例,3级2例,其余为4级或5级。(3)16例患者早期增强率≥60%,16例信号强度-时间(SI-Time)曲线为A型,3例为B型,1例为C型。结论早期乳腺癌MRI表现具有一定特征性,动态增强MRI联合X线可提高其诊断准确性。
Objective To investigate the diagnostic value of dynamic contrast-enhanced MRI in early stage breast cancer. Methods 20 cases of early breast cancer dynamic enhanced MRI data. Among them, ductal papillary carcinoma in 2 cases, ductal carcinoma in situ in 4 cases, ductal carcinoma in situ with microinvasion in 12 cases, lobular carcinoma in situ in 2 cases. Summary of early breast cancer characteristic MRI findings. Results (1) MRI features of focal enhancement: focal enhancement in 2 cases; catheter-like and section-like enhancement in 8 cases; mass enhancement in 10 cases, of which 9 cases had burr and irregular edge, 1 case had smooth edge, Seven cases were strengthened, of which two cases were uniform center enhanced and one case separated and strengthened. Breast Imaging Reporting and Data System (BI-RADS) grading: 1 in 1 case, 3 in 2 cases and the rest in 4 or 5 levels. (2) The results of X-ray examination: negative in 3 cases, tiny cluster calcification in 5 cases, linear calcification in 2 cases, mass in 6 cases, structural distortion in 2 cases and patch shadow in 2 cases. BI-RADS classification: grade 1 in 3 cases, grade 2 in 1 case, grade 3 in 2 cases, and the rest in 4 or 5 levels. (3) The early-stage enhancement rate of ≥60% in 16 patients was 16 cases with type-A signal-time curve, 3 cases with type B and 1 case with type C. Conclusion The MRI features of early breast cancer have certain characteristics. Dynamic contrast-enhanced MRI combined with X-ray can improve the diagnostic accuracy.