摘要
目的观察乳腺纤维腺瘤的多种MRI表现，分析其病理基础，从而加深对纤维腺瘤的认识，提高MRI诊断准确率。方法对33例乳腺纤维腺瘤患者（38个病灶），行常规MR平扫和动态增强检查。所有病例均经病理证实，分析比较病灶的MRI形态学、信号强度及其动态增强特点等。结果33例38个乳腺纤维腺瘤的形态学表现以分叶状、类圆形为主，占89．5％（34／38）。MRI显示内部信号多较均匀，T1WI呈等、低信号，T2WI信号多样化，高信号者的黏液样变明显（平均指数1．9），间质细胞丰富（平均指数2．2）；呈低信号者间质多硬化，间质细胞分布稀疏。不同信号强度的2种指数差异有统计学意义（x^2值分别为11．267、10．415，P值均〈0．05）。肿瘤有完整的包膜，边界多清晰者占86．8％（33／38）。增强后无或轻度强化（5／38）、明显强化（33／38）；不同强化曲线的2种指数差异无统计学意义（x^2=1．171、2．861，P〉0．05）。强化程度与患者的年龄构成有一定的相关性，年龄较轻者，强化多明显。无强化分隔者（9／33），是由于瘤体内部间质纤维组织胶原化形成。结论乳腺纤维腺瘤的MR T2WI信号及强化程度表现多样化，和其瘤体内黏液硬化程度及间质细胞含量相关。认识纤维腺瘤的特征性MRI表现有助于鉴别诊断。
Objective To identify histopathologic correlates for the various MRI appearances of breast fibroadenomas. Methods Thirty-eight fibroadenomas in 33 patients （aged 24-57 years） examined with gadolonium-enhanced MR imaging were observed for signal intensity on T2-weighted images, contrast enhancement, shape, and internal septation, and these findings were correlated with histopathologic findings. All cases underwent surgery and were proved by pathology. Results （1） The lesion shape was lobular, or round in 34 of 38 fibroadenomas （89. 5 % ）. （2） The signal intensity on T1 -weighted images was less than or equal to that of fibroglandular tissue in all cases. The signal intensity on T2-weighted images was highly varible： high T2 signal intensity was associated with more myxomatous stromal （ mean myxoid-sclerotic index value of 1.9 ）, higher stromal cellularity （mean stromal cellularity index value of 2. 2 ）; Fibroadenomas with low T2 signal intensity had stromal that was nearly uniformly sclerotic （ mean myxoid-sclerotic index values of 2.8） and low stromal cellularity （ mean stromal-cellularity index value of 1.2）. Significant differences were found between these two groups, x^2 = 11. 267 and x^2 = 10. 415 （P 〈0. 05）. （3） 33 of 38 fibroadenomas （86. 8% ） had smooth borders. （4） The degree of contrast enhancement： negligible or no contrast material enhancement （ n = 5 ）, enhanced intensely （ n = 33）. But no significant differences were found between the index values of two groups,x^2 = 1.171 and x^2 =2. 861 （P 〉0. 05）, The degree of contrast enhancement was proved to be related to ages of patients. The enhancement was more intensely in younger patients. （5） Internal septations were identified within nine of 33 enhancing fibroadenomas （27.3%） and appeared to correlated with collagenous bands at histopatholigic analysis. Conclusions Fibroadenomas demonstrate marked histopathologic variability. The resultant variability in the MR appearance correlated with the degree of myxomatous or sclerotic and stromal cellularity. Lobulation and internal septation, which appear to reflect intrinsic growth patterns of fibroadenomas, may provide more reliable information for distinction. Familiarity with the diagnostic features would facilitate to make the differential diagnosis correctly.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第5期467-471,共5页
Chinese Journal of Radiology
关键词
乳腺肿瘤
纤维腺瘤
磁共振成像
病理学
Breast neoplasm
Fibroadenoma
Magnetic resonance imaging
Pathology
