Morris E A, Schwartz L H, Drotman M B, Kim S J, Tan L K, Liberman L, Abramson A F, Van Zee K J, Dershaw D D
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Radiology. 2000 Jan;214(1):67-72. doi: 10.1148/radiology.214.1.r00ja1667.
To evaluate the ability to use breast magnetic resonance (MR) imaging to assess disease extent in patients with posterior breast masses who are suspected to have tumor invasion into underlying muscle.
Nineteen patients with posterior breast masses underwent three-dimensional, gradient-echo, 1.5-T MR imaging before and after the administration of gadopentetate dimeglumine. Thirteen had deep palpable masses that were clinically determined to be fixed to the underlying chest wall. Twelve had mammographic findings that caused muscle involvement to be suspected, and seven had normal mammograms. All patients underwent surgery. MR images were reviewed and were correlated with histologic findings.
Enhancing masses were identified on MR images in all 19 patients. Five (26%) of the 19 patients had masses that abutted the muscles, with obliteration of the fat plane and muscle enhancement. All five had muscle involvement at surgery. In the remaining 14 (74%) patients, no enhancement of muscle was seen; none of these had invasion of the muscle at surgery.
Extension of adjacent tumor into underlying musculature was indicated by abnormal enhancement within these structures. Violation of the fat plane between tumor and muscle, without other findings, did not indicate tumor involvement of these deep structures.
评估利用乳腺磁共振成像（MRI）评估怀疑肿瘤侵犯胸壁深层肌肉的乳腺后位肿块患者疾病范围的能力。
19例乳腺后位肿块患者在静脉注射钆喷酸葡胺前后接受了1.5T三维梯度回波MRI检查。13例患者可触及深部肿块，临床判定肿块与胸壁深层固定。12例患者乳腺钼靶检查结果提示肌肉受累可疑，7例患者乳腺钼靶检查结果正常。所有患者均接受手术治疗。回顾MRI图像并与组织学结果进行对照。
19例患者的MRI图像均显示有强化肿块。19例患者中有5例（26%）肿块紧邻肌肉，脂肪层消失且肌肉强化。这5例患者手术时均有肌肉受累。其余14例（74%）患者未见肌肉强化，手术时均无肌肉侵犯。
这些结构内的异常强化提示相邻肿瘤已延伸至深层肌肉组织。肿瘤与肌肉间脂肪层消失而无其他表现，并不提示这些深部结构受肿瘤侵犯。
