Radiologic-Pathologic Correlation of Ductal Carcinoma in Situ
Radiologic-Pathologic Correlation of Ductal Carcinoma in Situ
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DOI：
10.1148/rg.305095073
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发表时间：
2010-09-01
期刊：
影响因子：
5.5
通讯作者：
Takahashi, Shoki
中科院分区：
文献类型：
--
作者：
Yamada, Takayuki;Mori, Naoko;Takahashi, Shoki
导管原位癌 (DCIS) 占乳房 X 光检查筛查发现的乳腺癌的 20%-25%。病变多种多样，通常根据其乳房X线照相特征和组织学特征（例如核分级和是否存在坏死）进行分类。 DCIS 中最常见的乳房 X 线检查发现是微钙化，但无坏死的低度病变与中度或高度病变相比，不太可能出现钙化。其他乳房X光检查结果可能包括质量或结构扭曲。磁共振 (MR) 成像在检测 DCIS 方面比乳房 X 光检查具有更高的灵敏度，并且在描绘疾病范围方面具有更高的准确性。 DCIS 的 MR 成像表现主要取决于导管周围或基质血管异常的存在和程度。非肿块状增强是最常见的 MR 成像发现，通常与内部聚集增强相关。动态 MR 研究中的增强动力学各不相同，并且没有任何动力学模式是 DCIS 特定核级别的特征。然而，延迟成像的动力学模式似乎确实与乳房X光检查结果相关：肿块病变显示出强烈的冲刷；细多形性、细线状和细线状分支钙化呈现平台强化模式；无定形钙化表现出持续增强。多探测器计算机断层扫描可能是 MR 成像的有用辅助手段，用于术前绘图。 (C) 北美放射学会，2010 年。放射摄影.rsna.org
Ductal carcinoma in situ (DCIS) accounts for 20%-25% of breast cancers detected at screening mammography. The lesions are diverse and commonly are classified on the basis of their mammographic features and histologic characteristics such as nuclear grade and presence or absence of necrosis. The most common mammographic finding in DCIS is microcalcifications, but a low-grade lesion without necrosis is less likely to manifest with calcifications than either an intermediate- or a high-grade lesion. Other mammographic findings might include a mass or architectural distortion. Magnetic resonance (MR) imaging has higher sensitivity than mammography for the detection of DCIS and greater accuracy for depicting the extent of disease. The MR imaging appearance of DCIS depends primarily on the presence and extent of abnormal periductal or stromal vascularity. Nonmasslike enhancement, the most common MR imaging finding, is often seen in association with clumped internal enhancement. The enhancement kinetics in dynamic MR studies vary, and no kinetic pattern is pathognomonic of a particular nuclear grade of DCIS. However, the kinetic pattern at delayed imaging does appear to be correlated with the mammographic findings: Mass lesions show strong washout; fine pleomorphic, fine linear, and fine linear-branching calcifications demonstrate a plateau enhancement pattern; and amorphous calcifications exhibit persistent enhancement. Multidetector computed tomography might be a useful adjunct to MR imaging for preoperative mapping. (C) RSNA, 2010 . radiographics.rsna.org