Matsubayashi R, Matsuo Y, Edakuni G, Satoh T, Tokunaga O, Kudo S
Departments of Pathology, Saga Medical School, Nabeshima 5-1-1, Saga, 849-8501, Japan.
Radiology. 2000 Dec;217(3):841-8. doi: 10.1148/radiology.217.3.r00dc07841.
To investigate the histologic bases of rim enhancement of breast masses demonstrated on dynamic contrast material-enhanced magnetic resonance (MR) images.
Dynamic MR images of breast lesions (invasive carcinoma, n = 29; other, n = 6) in 35 women were reviewed. In each patient, subtraction images of the dynamic contrast-enhanced study were obtained, and early and delayed rim enhancement and delayed internal enhancement were evaluated. The MR findings were correlated with the ratio of microvessel density of the peripheral to the central portion of the lesion, fibrosis, and other histologic features, including expression of vascular endothelial growth factor (VEGF) and transforming growth factor ss1.
Early rim enhancement was observed in 29% and delayed rim enhancement was noted in 60% of all patients. Small cancer nests, a high ratio of peripheral-to-central microvessel density, peripheral VEGF expression, and a low ratio of peripheral-to-central fibrosis were correlated with early rim enhancement. Delayed rim enhancement was correlated with a high degree of fibrosis and inflammatory changes. Delayed internal enhancement was correlated with a high degree of fibrosis.
Rim enhancement of breast lesions at MR imaging is due to a combination of angiogenesis, distribution and degree of fibrosis, expression pattern of VEGF, and various histologic features.
探讨动态对比剂增强磁共振（MR）图像上乳腺肿块边缘强化的组织学基础。
回顾了35名女性乳腺病变（浸润性癌，n = 29；其他，n = 6）的动态MR图像。对每位患者，获取动态对比增强研究的减影图像，并评估早期和延迟边缘强化以及延迟内部强化。将MR表现与病变外周与中央部分的微血管密度比值、纤维化及其他组织学特征（包括血管内皮生长因子（VEGF）和转化生长因子β1的表达）进行关联分析。
所有患者中，29%观察到早期边缘强化，60%观察到延迟边缘强化。小癌巢、外周与中央微血管密度的高比值、外周VEGF表达以及外周与中央纤维化的低比值与早期边缘强化相关。延迟边缘强化与高度纤维化和炎症改变相关。延迟内部强化与高度纤维化相关。
MR成像上乳腺病变的边缘强化是血管生成、纤维化的分布和程度、VEGF表达模式以及各种组织学特征共同作用的结果。
