Effectiveness of multi-detector row computed tomography in detection of the presence and extent of ductal carcinoma in situ
Effectiveness of multi-detector row computed tomography in detection of the presence and extent of ductal carcinoma in situ
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多排计算机断层扫描检测导管原位癌的存在和范围的有效性
DOI：
10.1007/s12282-012-0395-5
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发表时间：
2012
期刊：
影响因子：
4
通讯作者：
T. Moriya
中科院分区：
文献类型：
--
作者：
I. Kimijima;Kazuya Yoshida;R. Tamura;T. Moriya
由于导管原位癌（DCIS）病变可在导管小叶段广泛扩散，通常无可触及的肿瘤，因此在保乳手术中完全切除病变需要在术前影像学检查中确定病变的精确位置和范围。我们研究了多探测器行计算机断层扫描（MDCT）在检测和描绘DCIS病变方面的潜力。方法74例75个DCIS病变行乳腺MDCT检查。在体积绘制图像中测量每个患者DCIS病变的大小，并与病理作图获得的大小进行比较。计算实际肿瘤大小与MDCT （L-Path和L-CT）的差异，并探讨这些差异与肿瘤特征之间的关系。结果75个病变中64个（84.9%）完全或部分检出dcis， MRI检出率为90%。其检出率不受是否有粉刺的影响，但高核级DCIS病变检出率往往高于低核级病变（p= 0.089），而高核级DCIS病变的估计大小也更准确（p= 0.046）。激素受体和Her2状态不影响MDCT结果。结论多层螺旋ct对DCIS有较高的诊断价值，尤其是对侵袭性较强的DCIS。此外，MDCT成像时患者的体位与手术时的体位比MRI更相似，这使得MDCT成为评估DCIS的一种非常有用的术前成像技术。
BackgroundAs ductal carcinoma in situ (DCIS) lesions can spread widely in the ductal-lobular segment, often without palpable tumor, complete resection of the lesion in breast-conserving surgery requires establishment of the precise location and extent of the lesion during preoperative imaging studies. We investigated the potential of multi-detector row computed tomography (MDCT) in detecting and delineating DCIS lesions.MethodsOverall, 74 patients with 75 DCIS lesions underwent breast MDCT. The size of the DCIS lesion in each patient was measured in the volume rendering images and compared to the size obtained by pathological mapping. The differences between the actual tumor size and that obtained from MDCT (L-Path and L-CT) were calculated, and the relationships between these differences and tumor characteristics were investigated.ResultsDCIS was detected fully or partially in 64 (84.9 %) of 75 lesions, whereas the detection rate of magnetic resonance imaging (MRI) was 90 %. The detection rate was not influenced by comedo/non-comedo status, but the detection rate of higher nuclear grade DCIS lesions tended to be higher than that of low grade lesions (p= 0.089), while the estimated size was also more accurate in the former (p= 0.046). Hormone receptor and Her2 status did not affect MDCT findings.ConclusionMDCT is highly effective for detecting DCIS, especially the more aggressive types of DCIS. Moreover, the patient’s position during MDCT imaging is more similar to that during surgery than that during MRI, making MDCT a highly useful presurgical imaging technique for the assessment of DCIS.