Munot K, Dall B, Achuthan R, Parkin G, Lane S, Horgan K
Department of Surgery, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK.
Br J Surg. 2002 Oct;89(10):1296-301. doi: 10.1046/j.1365-2168.2002.02208.x.
Conventional imaging with mammography and ultrasonography has a low sensitivity for diagnosis and a tendency to underestimate the extent of invasive lobular carcinoma (ILC) of the breast. The aim was to determine whether magnetic resonance imaging (MRI) had any advantages for the characterization of ILC.
Twenty patients with histologically proven ILC underwent preoperative imaging with MRI. MRI was performed to aid detection of malignancy in six patients with a clinically suspicious presentation but normal or indeterminate imaging on mammography and ultrasonography. In 14 patients MRI was performed to determine tumour extent.
MRI accurately identified malignancy in five of six patients with normal or indeterminate conventional imaging. In seven of 14 patients in whom MRI was performed to determine tumour extent, it provided significant additional information. These included four patients in whom conventional imaging grossly underestimated tumour size, two patients in whom MRI identified an unsuspected contralateral breast tumour and one patient in whom MRI predicted tumour invasion of the pectoral muscle. The correlation between tumour size on histological examination was better with MRI (r = 0.967) than with mammography (r = 0.663) and ultrasonography (r = 0.673).
MRI can provide considerable additional information in the detection and characterization of ILC.
传统的乳房X线摄影和超声成像对乳腺癌的诊断敏感性较低，且有低估乳腺浸润性小叶癌（ILC）范围的倾向。本研究旨在确定磁共振成像（MRI）在ILC特征描述方面是否具有优势。
20例经组织学证实为ILC的患者术前行MRI检查。6例临床可疑但乳房X线摄影和超声成像正常或不确定的患者行MRI检查以辅助检测恶性肿瘤。14例患者行MRI检查以确定肿瘤范围。
6例传统成像正常或不确定的患者中，MRI准确识别出5例恶性肿瘤。14例行MRI检查以确定肿瘤范围的患者中，7例获得了重要的额外信息。其中包括4例传统成像严重低估肿瘤大小的患者，2例MRI发现对侧乳房意外肿瘤的患者，以及1例MRI预测肿瘤侵犯胸肌的患者。MRI检查与组织学检查的肿瘤大小相关性（r = 0.967）优于乳房X线摄影（r = 0.663）和超声检查（r = 0.673）。
MRI在ILC的检测和特征描述方面可提供大量额外信息。
