乳腺良恶性叶状肿瘤MRI表现及病理特征分析

目的：分析良恶性乳腺叶状肿瘤（PT）的MRI表现特征及其与病理的相关性。材料与方法回顾性分析于我院行术前MRI并经手术病理证实的16例PT影像学表现，比较良恶性组间差异，并分析BI-RADS分类评估与病理分类间相关性。结果（1）16例PT术后病理诊断良性10例、交界性4例、恶性2例；其中2例恶性者均有乳腺肿瘤手术史。（2）T1WI以等信号为主、STIR以高信号为主，大病灶内部更易出血、变性而呈混杂信号。（3）非良性组直径更大、更易呈多结节融合状、TIC更易呈流出型、ADC值更低。（4）MRI对PT的检出率为100%，对PT良恶性判断的准确率为62.5%；BI-RADS分类与PT病理低度相关。结论乳腺叶状肿瘤MRI表现多样， MRI对PT的诊断有一定提示作用，穿刺活检甚至术中冰冻对PT的诊断不可靠，确诊仍需对整个病灶行组织病理学检查。

MRI features of phyllodes tumor in breast with pathological correlation

Objective：To study the MRI features of breast phyllodes tumor and to correlate them to different pathological types. Materials and methods：Clinical and imaging ifndings of 16 patients with pathologically conifrmed PT were retrospectively reviewed. All of these 16 patients had pre-operative MRI, which were interpreted by 2 experienced radiologists according to BI-RADS classification. Inter-group comparisons were performed between benign and malignant PT based on pathological findings. Results：The pathologic findings were benign, borderline, and malignant in 10, 4, and 2 cases. Both 2 malignant cases had previous breast tumor excision. PT showed isointensity on non-contrast enhanced T1WI and hyperintensity on STIR, while large lesions showed heterogenous internal signal intensity. Non-benign PT tended to be featured with larger diameter, confluent multinodular, type III TIC and lower ADC. MRI detected 100% PT lesions with a diagnostic accuracy of 62.5%. BI-RADS classification results showed low correlation with pathological results. Conclusions：MRI features of breast PT are diverse. Breast MRI has certain advantages in preoperative diagnosis of PT, while the ifnal diagnosis should only be based upon carefully histopathological examination of the whole lesion.