Daniel Bruce L, Gardner Robert W, Birdwell Robyn L, Nowels Kent W, Johnson Denise
Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA.
Magn Reson Imaging. 2003 Oct;21(8):887-92. doi: 10.1016/s0730-725x(03)00192-9.
To describe the appearance of isolated intraductal papilloma on contrast-enhanced water-specific, high spatial-resolution and rapid dynamic breast MRI, a retrospective review of unilateral breast images of 15 pathologically proven papilloma was performed. MRI revealed three patterns: Four papillomas were small, smooth, enhancing masses at the posterior end of an enlarged duct, corresponding to the "small lumenal mass" appearance of papilloma known from galactography. MRI detected two of these "small lumenal mass" papillomas in patients with abnormal nipple discharge even when galactography was unsuccessful. Seven papillomas were irregular enhancing masses detected in patients without nipple discharge. None of these papillomas had specifically benign findings. All seven demonstrated rapid enhancement and three showed rim enhancement or spiculation. These "tumor-like" papillomas mimicked invasive breast cancer on MRI. Four papillomas were occult on MRI, not revealed by either contrast-enhanced MRI or fat-suppressed T(2)-weighted MRI. Intraductal papillomas present with a variable appearance on MRI ranging from occult to "small lumenal mass" papillomas to irregular rapidly enhancing lesions that cannot be distinguished from invasive cancers.
为描述孤立性导管内乳头状瘤在对比增强水特异性、高空间分辨率和快速动态乳腺MRI上的表现，对15例经病理证实的乳头状瘤的单侧乳腺图像进行了回顾性研究。MRI显示出三种模式：四个乳头状瘤为小的、光滑的、在扩张导管后端强化的肿块，对应于乳腺导管造影中已知的乳头状瘤的“小腔内肿块”表现。即使乳腺导管造影未成功，MRI在乳头溢液异常的患者中检测到了其中两个“小腔内肿块”乳头状瘤。七个乳头状瘤是在无乳头溢液的患者中检测到的不规则强化肿块。这些乳头状瘤均无明确的良性表现。所有七个均表现为快速强化，三个表现为边缘强化或毛刺征。这些“肿瘤样”乳头状瘤在MRI上类似浸润性乳腺癌。四个乳头状瘤在MRI上隐匿，对比增强MRI或脂肪抑制T2加权MRI均未显示。导管内乳头状瘤在MRI上表现多样，从隐匿性到“小腔内肿块”乳头状瘤，再到无法与浸润性癌区分的不规则快速强化病变。
