【摘要】 目的 探究多模态磁共振(MRI)影像对乳腺叶状肿瘤分级诊断的价值。方法 对2015年2月至2024年1月在北京大学深圳医院经手术切除病理确诊为乳腺叶状肿瘤,并术前有MRI检查的49个患者(50例病灶)进行回顾性分析,包括常规平扫T1WI、T2WI、扩散加权成像(DWI)、动态增强扫描(DCE-MRI),以病理结果为“金标准”,研究多模态MRI对乳腺叶状肿瘤分级诊断的价值。结果50例研究对象包括良性26例(52%)、交界性15例(30%)、恶性9例(18%);肿瘤的边缘、形态、内部坏死囊变及分隔强化特征、实性部分ADC、瘤周水肿等组间有统计学差异(P<0.001),使用Spearman相关分析发现肿瘤的边缘模糊/毛刺、形态不规则/分叶、内部坏死/囊变、分隔强化、壁厚薄不均匀、ADC低信号、瘤周水肿的特征与叶状肿瘤恶性程度显著线性相关。结论动态增强扫描(DCE-MRI)、表观弥散系数(ADC)联合T2WI的多模态MRI参数对预测乳腺叶状肿瘤分级诊断具有临床应用价值。更多还原

【Abstract】 Objective To explore the value of multimodal magnetic resonance(MRI) imaging in the graded diagnosis of breast phyllodes tumors.Methods A retrospective analysis was conducted on 50 lesions admitted to Peking University Shenzhen Hospital from February 2015 to January 2024 with surgical resection pathologically confirmed as phyllodes tumors of the breast and preoperative MRI examinations,all including conventional MRI sequences T1WI,T2WI,diffusion-weighted imaging DWI,dynamic enhanced scan(DCE-MRI) and surgical resection pathological examination,with pathological results as the "gold standard",to study the value of multimodal MRI signs in the graded diagnosis of breast phyllodes tumors.Results Among the 50 study subjects,26 cases(52%) were benign,15(30%)were borderline,and 9 cases(18%) were divided into three groups:benign,borderline,and malignant.There were statistical differences in the margins,morphology,internal necrosis cystic degeneration and septial enhancement characteristics,solid part of ADC,and peritumoral edema among the three groups of multimodal MRI signs(P<0.001),and Spearman correlation analysis was performed to show a significant linear correlation between these signs |r|<0.5.Conclusion The multimodal MRI parameters of T2WI,dynamic contrast-enhanced MRI(DCE-MRI) and apparent diffusion coefficient(ADC) have clinical value in predicting the grading of breast phyllodes tumors.更多还原