Objective: To explore the MRI features of the pure mucinous breast carcinoma(PMBC) and the correlation with cell density and the expression of immunohistochemistry. Methods: MRI features of 35 pure mucinous carcinomas were retrospectively analyzed from January 2011 to May 2016 in Guangdong General Hospital. MR images were reviewed for shape, margin, the signal intensity, enhancement patterns of tumors and diffusion weighted imaging (DWI) features and apparent diffusion coefficient (ADC) value. All the patients were detected by immunohistochemical staining with expression of ER, PR, CerbB-2, Ki-67 and Her-2. Correlations between MRI features of PMBC and cell density and the expression of immunohistochemistry were analyzed. Results: A total of 16 oval masses(16/35, 45.7%) and 10 round masses(10/35, 28.6%)were found in 35 PMBC with clear boundary(26/35, 74.3%) and lobulated shape(31/35, 88.6%). Very high signal intensity on T(2)-weighted images was found in 33 PMBC (33/35, 94.3%) and early enhancement rate was 115%±9% for PMBC. 28 PMBC demonstrated persistent enhancing pattern on time-signal intensity curve and 7 PMBC demonstrated plateau pattern.Mean ADC value was (1.91±0.06)×10(-3)mm(2)/s for PMBC. There was significant difference with early enhancement rate and ADC value between PMBC with more or less quantities of cellular mucin (P<0.05). There was no significant difference with ER, PR, CerbB-2, Her-2 and Ki-67 expression between PMBC with more or less quantities of cellular mucin (all P>0.05). Conclusions: PMBC has distinctive MRI features. The prognosis of PMBC is better from correlation between MRI features, cell density and the expression of immunohistochemistry.
目的： 探讨乳腺单纯型黏液癌(PMBC)的磁共振成像(MRI)表现及与细胞密度、免疫组化的相关性。 方法： 回顾性分析广东省人民医院2011年1月至2016年5月经手术病理证实的35例PMBC患者的MRI资料，分析其形态学特征、T(1)WI及T(2)WI信号特点、动态增强模式、扩散加权成像(DWI)信号及表观扩散系数(ADC)值，并与细胞密度、免疫组化指标(ER、PR、CerbB－2、Her－2、Ki－67等)相对照。 结果： PMBC以椭圆形(16/35，45.7%)、圆形(10/35，28.6%)多见，且边界清晰(26/35，74.3%)，多有分叶(31/35，88.6%)，T(2)WI为明显高信号(33/35，94.3%)，早期强化率平均为115%±9%；时间－信号强度曲线(TIC)Ⅰ型28例，Ⅱ型7例，ADC值(1.91±0.06)×10(－3) mm(2)/s。不同细胞密度(富于细胞型、少细胞型)的PMBC与早期强化率呈正相关，同ADC值呈负相关(P<0.05)，与内部强化特征、TIC曲线无明显相关性(P>0.05)，两组间的ER、PR、CerbB－2、Ki－67、Her－2阳性率差异均无统计学意义(均P>0.05)。 结论： PMBC的MRI征象具有特征性，分析其与细胞密度、免疫组化的相关性，提示PMBC预后较好。.
Keywords: Breast neoplasms; Diffusion weighted imaging; Magnetic resonance imaging.