Sarica Ozgur, Dokdok Murat
Department of Radiology, Anadolu Medical Center, Gebze Kocaeli, Turkey.
J Comput Assist Tomogr. 2018 Jul/Aug;42(4):542-551. doi: 10.1097/RCT.0000000000000739.
This study aims to analyze the imaging features of dilated ducts or ductal extension/relation of masses detected by ultrasound (US) and magnetic resonance imaging (MRI) and to correlate the results obtained through these 2 different imaging methods. Furthermore, the ability of the ductal relation pattern in differentiating benign and malignant lesions was explored.
Magnetic resonance imaging and US findings of 56 patients who had a pathologic diagnosis of papillary lesion were examined. Ductal findings were classified into four types for both imaging methods: intraductal form, extraductal form, mixed form, and no ductal relation. The correlation between MRI and US was then analyzed with respect to ductal findings. Statistical analyses were performed to determine the value of ductal patterns determined by these 2 imaging methods in the differentiation of benign and malignant papillary lesions.
A total of 56 cases with papillomatosis (n = 11), papillomas (n = 29), and papillary breast carcinomas (n = 16) were included. There was a statistically significant correlation between all ductal patterns on US and the corresponding ductal signs on MRI. Palpable masses were statistically more common in patients with papillary breast carcinoma compared with other groups (P < 0.01). Segmental contrast enhancement occurred at a significantly higher rate in papillary breast carcinoma and papillomatosis patients, as compared with papilloma patients (P < 0.05).
Actual resolution of MRI is close to that of US in terms of the ability to demonstrate the ductal relation of masses. Segmental contrast enhancement on MRI and nonmass-like heterogeneous hypoechoic area or mass with multiple ductal extensions on US can be used in discriminating benign versus malignant papillary lesions. The absence of ductal sign in MRI indicates benignity.
本研究旨在分析超声（US）和磁共振成像（MRI）检测到的扩张导管或肿块的导管延伸/关系的成像特征，并关联通过这两种不同成像方法获得的结果。此外，还探讨了导管关系模式在鉴别良性和恶性病变中的能力。
对56例经病理诊断为乳头状病变的患者的磁共振成像和超声检查结果进行了分析。两种成像方法的导管表现均分为四种类型：导管内型、导管外型、混合型和无导管关系型。然后分析MRI和US在导管表现方面的相关性。进行统计分析以确定这两种成像方法确定的导管模式在鉴别良性和恶性乳头状病变中的价值。
共纳入56例病例，其中乳头瘤病11例、乳头状瘤29例和乳腺乳头状癌16例。US上所有导管模式与MRI上相应的导管征象之间存在统计学显著相关性。与其他组相比，乳腺乳头状癌患者中可触及肿块在统计学上更为常见（P < 0.01）。与乳头状瘤患者相比，乳腺乳头状癌和乳头瘤病患者节段性对比增强发生率显著更高（P < 0.05）。
在显示肿块的导管关系方面，MRI的实际分辨率与US接近。MRI上的节段性对比增强以及US上的非肿块样不均匀低回声区或具有多个导管延伸的肿块可用于鉴别良性与恶性乳头状病变。MRI上无导管征象提示为良性。
