Zhang Yili, Du Hongwen
Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
Mol Clin Oncol. 2016 Aug;5(2):388-394. doi: 10.3892/mco.2016.923. Epub 2016 Jun 9.
The aim of the present study was to evaluate the role of short-term follow-up magnetic resonance imaging (MRI) in the detection of postoperative residual breast cancer. A retrospective analysis was performed on 10 patients who were diagnosed with non-malignant breast lesions by preoperative clinical, ultrasound and mammography examinations and intraoperative frozen-section pathology. These patients were finally confirmed as having malignant breast lesions by paraffin-embedded tissue histology and corresponding received second surgeries. Routine MRI, enhancement MRI and echo-planar imaging-diffusion-weighted imaging were performed on the 10 patients within 1 month after the first surgery. All the cases showed a local distortion of mammary architecture revealed by routine MRI and enhancement MRI images. The enhancement characteristics of the 10 cases were as follows: 3 cases featured stippled enhancement, 2 had small nodular enhancement, 1 showed dendritic enhancement, 1 had a ring-shaped enhancement of the cystic wall and 3 had no abnormal enhancement. The lesions of 7 cases had a type-I enhancement curve (progressive enhancement pattern) and 3 cases had a type-II curve (plateau pattern). The lesions of 4 cases had a decreased apparent diffusion coefficient. In total, 4 cases of tumor residue were diagnosed by MRI and the second pathological examination, while in 1 case the tumor residue was misdiagnosed by MRI but confirmed by the second pathological examination. In conclusion, the present study suggested that short-term follow-up MRI may be of value in the diagnosis of postoperative residual breast tumors and may be helpful for surgeons to develop an accurate surgical plan.
本研究的目的是评估短期随访磁共振成像(MRI)在检测术后残留乳腺癌中的作用。对10例患者进行回顾性分析,这些患者术前经临床、超声和乳腺X线检查以及术中冰冻切片病理诊断为非恶性乳腺病变。这些患者最终经石蜡包埋组织组织学确诊为恶性乳腺病变,并相应接受了二次手术。在首次手术后1个月内对这10例患者进行了常规MRI、增强MRI和回波平面成像 - 扩散加权成像检查。所有病例的常规MRI和增强MRI图像均显示乳腺结构局部扭曲。这10例病例的增强特征如下:3例为点状增强,2例为小结节状增强,1例为树枝状增强,1例为囊壁环形增强,3例无异常增强。7例病变呈I型增强曲线(渐进性增强模式),3例呈II型曲线(平台型模式)。4例病变的表观扩散系数降低。MRI和二次病理检查共诊断出4例肿瘤残留,1例肿瘤残留MRI误诊但二次病理检查确诊。总之,本研究表明短期随访MRI可能对术后残留乳腺肿瘤的诊断有价值,可能有助于外科医生制定准确的手术方案。