Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 57, Houston, TX 77030, USA.
AJR Am J Roentgenol. 2011 Oct;197(4):W769-76. doi: 10.2214/AJR.10.6157.
The aim of this study was to evaluate the features of inflammatory breast carcinoma (IBC) on MRI compared with mammography and ultrasound and to better define the role of MRI in patients with this aggressive disease.
A retrospective analysis was performed of patients with newly diagnosed IBC evaluated at a single institution between 2003 and 2008. Baseline MRI examinations were performed on a 1.5- or 3-T scanner using contrast-enhanced 3D T1-weighted gradient-echo sequences with parallel imaging. MRI findings were rated in accordance with the BI-RADS MRI lexicon established by the American College of Radiology. All patients underwent concomitant mammography and ultrasound examinations.
Eighty women with a clinical diagnosis of IBC were included in the study (median age, 52 years; age range, 25-78 years). MRI detected a primary breast lesion in 78 of 80 symptomatic breasts (98%) compared with 53 of 78 (68%) with mammography (p < 0.0001) and 75 of 80 (94%) with ultrasound. Of the 78 breasts with a primary lesion, the most common MRI finding was a mass or multiple masses (57/78, 73%). Masses were frequently multiple, small, and confluent (47/57, 82%); mass margins, irregular (43/57, 75%); and internal enhancement pattern, heterogeneous (47/57, 82%). Kinetic analysis revealed a delayed washout pattern in 66 of 78 tumors (85%). MRI showed skin thickening in 74 of 80 breasts (93%), whereas mammography showed skin thickening in 56 of 78 breasts (72%).
Multiple small, confluent, heterogeneously enhancing masses and global skin thickening are key MRI features of IBC that contribute to improved detection of a primary breast cancer and delineation of disease extent compared with mammography.
本研究旨在评估炎症性乳腺癌（IBC）的 MRI 表现，与乳腺钼靶摄影和超声检查进行对比，并更好地定义 MRI 在这种侵袭性疾病患者中的作用。
回顾性分析了 2003 年至 2008 年在一家机构新诊断为 IBC 的患者。使用对比增强 3D T1 加权梯度回波序列和平行采集技术，在 1.5 或 3T 扫描仪上进行基线 MRI 检查。MRI 发现按照美国放射学院（ACR）建立的 BI-RADS MRI 词汇进行评分。所有患者均同时接受乳腺钼靶摄影和超声检查。
本研究纳入了 80 例临床诊断为 IBC 的女性患者（中位年龄 52 岁；年龄范围 25-78 岁）。与乳腺钼靶摄影（53/78，68%）相比，MRI 检测到 80 例有症状乳房中的 78 例（98%）原发性乳腺病变，而超声检测到 80 例中的 75 例（94%）。在 78 例有原发性病变的乳房中，最常见的 MRI 表现是肿块或多个肿块（57/78，73%）。肿块通常是多发的、小的、融合的（47/57，82%）；肿块边缘不规则（43/57，75%）；内部强化模式不均匀（47/57，82%）。动力学分析显示 78 个肿瘤中有 66 个（85%）呈延迟廓清模式。MRI 显示 80 例乳房中有 74 例（93%）存在皮肤增厚，而乳腺钼靶摄影显示 78 例乳房中有 56 例（72%）存在皮肤增厚。
多发的、小的、融合的、不均匀强化的肿块和弥漫性皮肤增厚是 IBC 的关键 MRI 特征，与乳腺钼靶摄影相比，这些特征可提高对原发性乳腺癌的检出率，并有助于描绘疾病的范围。
