Yabuuchi Hidetake, Soeda Hiroyasu, Matsuo Yoshio, Okafuji Takashi, Eguchi Takashi, Sakai Shuji, Kuroki Syoji, Tokunaga Eriko, Ohno Shinji, Nishiyama Kenichi, Hatakenaka Masamitsu, Honda Hiroshi
Department of Clinical Radiology, Kyushu University, Japan.
Radiology. 2006 Dec;241(3):702-9. doi: 10.1148/radiol.2413051470. Epub 2006 Oct 10.
To retrospectively evaluate the magnetic resonance (MR) imaging findings of phyllodes tumor of the breast and to compare these findings with the histologic grade.
Institutional review board approval and informed consent were obtained. The authors reviewed the MR findings in 30 female patients aged 16-73 years (mean, 40.2 years) with surgically confirmed phyllodes tumors. Analyzed MR findings included tumor shape, margin, internal enhancement, and size; signal intensity (SI) of tumor higher than that of normal breast tissue on T1-weighted images; SI of tumor lower than or equal to that of normal tissue on T2-weighted images; cyst wall appearance; kinetic curve assessment; and apparent diffusion coefficient (ADC). The MR findings and histologic grade were statistically analyzed to determine whether any correlations existed. Significant MR findings were compared with histopathologic findings.
Nineteen benign, six intermediate (characterized by five to nine cell reproductions at 10 high-power fields, pushing or infiltrative margins, moderate stromal cellularity, and atypia and overgrowth), and five malignant phyllodes tumors were assessed. Irregular cyst wall (P = .003), tumor SI lower than or equal to normal tissue SI on T2-weighted images (P = .005), and low ADC (P = .001) correlated significantly with histologic grade. Tumor SI higher than normal tissue SI on T1-weighted images was more frequent in the malignant (in three of five tumors) and intermediate (in three of six tumors) groups than in the benign group (in two of 19 tumors); however, it was not a significant finding (P = .024). Tumor SI higher than normal tissue SI on T1-weighted images and irregular cyst wall corresponded histopathologically to hemorrhagic infarction and necrosis, respectively. Tumor SI lower than or equal to normal tissue SI on T2-weighted images and low ADC corresponded histopathologically to stromal hypercellularity. Other findings were not significant.
Several MR findings can be used to help determine the histologic grade of phyllodes breast tumors.
回顾性评估乳腺叶状肿瘤的磁共振（MR）成像表现，并将这些表现与组织学分级进行比较。
获得机构审查委员会批准并取得知情同意。作者回顾了30例年龄在16 - 73岁（平均40.2岁）经手术确诊为叶状肿瘤的女性患者的MR表现。分析的MR表现包括肿瘤形状、边缘、内部强化及大小；肿瘤在T1加权图像上的信号强度（SI）高于正常乳腺组织；肿瘤在T2加权图像上的SI低于或等于正常组织；囊壁外观；动态曲线评估；以及表观扩散系数（ADC）。对MR表现和组织学分级进行统计学分析以确定是否存在相关性。将显著的MR表现与组织病理学结果进行比较。
评估了19例良性、6例中间型（其特征为在10个高倍视野中有5至9个细胞增殖、推挤或浸润性边缘、中等间质细胞密度、异型性及过度生长）和5例恶性叶状肿瘤。不规则囊壁（P = .003）、肿瘤在T2加权图像上的SI低于或等于正常组织SI（P = .005）以及低ADC（P = .001）与组织学分级显著相关。肿瘤在T1加权图像上的SI高于正常组织SI在恶性组（5例肿瘤中的3例）和中间型组（6例肿瘤中的3例）比良性组（19例肿瘤中的2例）更常见；然而，这并非显著发现（P = .024）。肿瘤在T1加权图像上的SI高于正常组织SI和不规则囊壁在组织病理学上分别对应出血性梗死和坏死。肿瘤在T2加权图像上的SI低于或等于正常组织SI和低ADC在组织病理学上对应间质细胞增多。其他表现不显著。
几种MR表现可用于帮助确定乳腺叶状肿瘤的组织学分级。
