乳腺密度对浸润性小叶癌术前MRI评估的影响

目的:探讨MRI在浸润性小叶癌(ILC)术前诊断中的应用价值，并评估乳腺密度对其影响。方法:选取75例术前30天内行MRI检查的I-Ⅲ期ILC患者列入本项研究，根据腺体含量评估乳腺密度，在MRI下测量肿瘤大小，并对比其与病理大小的一致性。结果:75例入组患者中26例（34.7%）患者经MRI评估发现新的可疑病灶，20例（26.7%）患者改变了手术方式。高密度乳腺型患者额外病灶检出率明显高于低密度乳腺型患者（51.6% vs 22.7%，P=0.010）。MRI评估肿瘤大小在低密度乳腺型患者中容易被低估（36.4% vs 12.9%，P=0.024），在高密度乳腺型患者中容易被高估（6.8% vs 29.0%，P=0.010），但两组患者与病理大小一致性的比例无明显差异。结论:ILC患者术前乳腺MRI检查能够提高额外恶性肿瘤的检出率，而乳腺密度是影响MRI评估的重要因素。

Evaluating the impact of breast density on preoperative MRI in invasive lobular carcinoma

Objective:To investigate the effect of breast density on the application of MRI in preoperative diagnosis of invasive lobular carcinoma.Methods:Seventy-five patients with stage I-Ⅲ ILC who underwent MRI examination within 30 days before surgery were included in this study.Breast density was evaluated based on gland content.Tumor size was measured under MRI，and its consistency with pathological size was compared.Results:Of the 75 enrolled patients，26 cases（34.7%) found new suspicious lesions through MRI evaluation，and 20 cases（26.7%) changed the surgical methods.The detection rate of additional lesions in high density breast type patients was significantly higher than that in low density breast type patients（51.6% vs 22.7%，P=0.010).MRI evaluation of tumor size was easily underestimated in patients with low density breast type（36.4% vs 12.9%，P=0.024) and overestimated in patients with high density breast type（6.8% vs 29.0%，P=0.010)，but there was no significant difference in the proportion of size consistency between the two groups.Conclusion:Preoperative breast MRI in ILC patients can improve the detection rate of additional malignant tumors，and breast density is an important factor affecting MRI evaluation.