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短期随访磁共振成像在检测术后残留乳腺癌中的作用

Role of short-term follow-up magnetic resonance imaging in the detection of post-operative residual breast cancer.

作者信息

Zhang Yili, Du Hongwen

机构信息

Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.

出版信息

Mol Clin Oncol. 2016 Aug;5(2):388-394. doi: 10.3892/mco.2016.923. Epub 2016 Jun 9.

Abstract

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.

摘要

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。

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