Diagnostic value of multimodal MR in differentiating fibroadenoma from phyllodes tumor with maximum diameter≥5 cm
10.3969/j.issn.1002-1671.2024.03.008
- VernacularTitle:多模态MR对≥5 cm的纤维腺瘤和叶状肿瘤鉴别诊断价值
- Author:
Lijia WANG
1
;
Hui FENG
;
Jiangyang PAN
;
Qian XU
;
Qi WANG
Author Information
1. 河北医科大学第四医院CT&MRI科,河北 石家庄 050011
- Keywords:
breast fibroadenoma;
breast phyllodes tumor;
magnetic resonance imaging
- From:
Journal of Practical Radiology
2024;40(3):377-380,410
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical and MR characteristics of fibroadenoma(FA)and phyllodes tumor(PT)with maxi-mum diameter≥5 cm.Methods A total of 33 cases with FA and 34 cases with PT were selected,and all lesions with maximum diameter≥5 cm were confirmed by surgical pathology.The clinical and MR characteristics were analyzed retrospectively.Results PT and FA with tumor maximum diameter≥5 cm were more common in perimenopausal women[(47.35±11.36)years old vs(49.42±11.73)years old,P>0.05],while the FA patient was with the wider age range(19-79 years old).There was statistically significant difference in tumor maximum diameter between PT group and FA group(P<0.001),and tumor maximum diameter of PT group(median 7.06 cm,tumor maximum diameter 17.3 cm)was significantly larger than that of FA group.Coarse calcification was more common in the FA group compared to the PT group(5 vs 0,P=0.011).High signal on T1WI was more common in PT group rela-tive to FA group(50%vs 9.1%,P<0.001).There were no significant differences between the two groups in four characteristics,including tumor margin lobulation(97.1%vs 81.8%),T2WI low signal separation(32.4%vs 30.3%),fibroglandular tissue(FGT),and background parenchymal enhancement(BPE)(P>0.05).Time-signal intensity curve(TIC)of FA group showed typeⅠ and Ⅱ curves,while 4 cases(11.8%)in PT group showed type Ⅲ curves,and there was statistically significant difference in TIC between the two groups(P=0.008).The apparent diffusion coefficient(ADC)values of PT group[(1.48±0.17)×10-3mm2/s]was slightly lower than that of FA group[(1.55±0.20)×10-3 mm2/s],and there was no significant difference in ADC between the two groups(P>0.05).The receiver operating characteristic(ROC)curve showed that the best diagnostic cut-off value for distinguishing between PT and FA with maximum diameter≥5 cm was 6.36 cm,the area under the curve(AUC)was 0.927[95%confidence in-terval(CI)0.860-0.994;P<0.001].The AUC of the T1 WI high signal was 0.705,and the standard error was 0.065(95%CI 0.578-0.831;P=0.004).Conclusion Among FA and PT with tumor maximum diameter≥5 cm,PT appear to be more larger lesion and prone to higher signal intensity on T1WI compared to FA,while coarse calcification is more common in FA.