Satake H, Shimamoto K, Sawaki A, Niimi R, Ando Y, Ishiguchi T, Ishigaki T, Yamakawa K, Nagasaka T, Funahashi H
Department of Radiology, Nagoya University School of Medicine, Japan.
Eur Radiol. 2000;10(11):1726-32. doi: 10.1007/s003300000465.
The purpose of this study was to assess the role of US in the detection of intraductal spread of breast cancer in comparison with mammography (MMG) and MRI. In 46 patients with breast cancer, US features of the intraductal component were classified as ductal type or distorted type. Histopathologically, 29 of 46 (63%) cases had intraductal components, and the sensitivity, specificity, and accuracy rates in detection of intraductal spread were 89, 76, and 85%, respectively. Each US pattern demonstrated good correspondence to the histologic components, and the distorted type correlated well with comedo-type carcinoma. Mammography was performed in all cases, and the sensitivity, specificity, and accuracy rates in detection of intraductal spread were 55, 100, and 72%, respectively. In comedo type, MMG could diagnose the extent of intraductal spread more accurately compared with US examination. Magnetic resonance imaging comparison was available in 25 cases. Magnetic resonance imaging depicted intraductal extension as an enhanced area during the early phase of a contrast enhancement study with a sensitivity of 93%. Ultrasound and MRI were closely related in terms of morphologic characteristics: the ductal type of US image correlated well with linear enhancement on MRI, whereas the distorted type correlated with regional or segmental enhancement. Current US examination is useful in depicting the intraductal spread of breast cancer; however, US has a tendency to underestimate intraductal component of comedo type compared with MMG and MRI.
本研究旨在评估超声（US）与乳腺X线摄影（MMG）及磁共振成像（MRI）相比，在检测乳腺癌导管内扩散方面的作用。46例乳腺癌患者中，导管内成分的超声特征分为导管型或扭曲型。组织病理学检查显示，46例中有29例（63%）存在导管内成分，检测导管内扩散的敏感性、特异性和准确率分别为89%、76%和85%。每种超声表现与组织学成分均有良好的对应关系，扭曲型与粉刺型癌相关性良好。所有病例均进行了乳腺X线摄影，检测导管内扩散的敏感性、特异性和准确率分别为55%、100%和72%。在粉刺型中，与超声检查相比，乳腺X线摄影能更准确地诊断导管内扩散的范围。25例患者进行了磁共振成像对比。磁共振成像在对比增强研究的早期阶段将导管内延伸显示为强化区域，敏感性为93%。超声和磁共振成像在形态学特征方面密切相关：超声图像的导管型与磁共振成像的线性强化相关性良好，而扭曲型与区域或节段性强化相关。目前的超声检查有助于描绘乳腺癌的导管内扩散；然而，与乳腺X线摄影和磁共振成像相比，超声有低估粉刺型导管内成分的倾向。
