Investigative Magnetic Resonance Imaging

  • 제14권1호
  • /
  • Pages.21-30
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  • 2010
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  • 2384-1095(pISSN)
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  • 2384-1109(eISSN)
대한자기공명의과학회 (Korean Society of Magnetic Resonance in Medicine)
권호 표지

점액암의 영상소견

Imaging Features of Mucinous Breast Carcinoma

  • 한혜정 (가톨릭대학교 의과대학 영상의학과) ;
  • 김성헌 (가톨릭대학교 의과대학 영상의학과) ;
  • 차은숙 (가톨릭대학교 의과대학 영상의학과) ;
  • 김현숙 (가톨릭대학교 의과대학 영상의학과) ;
  • 강봉주 (가톨릭대학교 의과대학 영상의학과) ;
  • 최재정 (가톨릭대학교 의과대학 영상의학과) ;
  • 이지혜 (가톨릭대학교 의과대학 영상의학과) ;
  • 이아원 (가톨릭대학교 의과대학 병리학과)
  • Han, Hye-Jung (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Sung-Hun (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Cha, Eun-Suk (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyun-Sook (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kang, Bong-Joo (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jae-Jung (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jee-Hye (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Ah-Won (Department of Pathology, College of Medicine, The Catholic University of Korea)
  • 투고 : 2010.01.20
  • 심사 : 2010.04.27
  • 발행 : 2010.06.30
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초록

목적: 점액암의 영상소견에 대해서 알아 보고, 조직학적 분화도에 따른 영상 소견의 차이를 알아보고자 하였다. 대상과 방법: 수술을 통해 점액암으로 확진된 29명의 환자를 대상으로 유방촬영술과 초음파 검사, 그리고 자기 공명 영상 소견을 BI-RADS에 따라서 후향적으로 분석하였다. 또한 점액암의 조직학적 분화도를 고분화, 중증도분화, 미분화 등급으로 나눠서 이에 따른 영상소견의 차이를 통계학적으로 분석하였다. 결과: 총 20예의 유방 촬영에서 17예 (85%)가 종괴로 보였고 3예는 정상소견이었다. 총 27예의 초음파 검사에서 점액암은 난원형 (59.2%)의 미세소엽성 변연 (55.5%)을 가지거나 불균일한 등에코 (74%)의 종괴로 보였다. 총 21예의 자기공명영상에서 점액암은 소엽상의 변연(76.2%), 매끄러운 변연(86%)의 종괴로 불균일한 조영증강(61.9%)을 보이는 경우가 흔하였다. 역동성 조영 증가 그래프에서 지연시 유실형 양상 (52.3%)을 보였다. 고분화 점액암이 갑자기 끝나는 종괴의 경계를 보이는 것 외에는 점액암의 분화도에 따른 영상소견의 차이는 없었다. 결론: 점액암의 분화도에 따른 차이는 중등도 분화 점액암과 비교하여 고분화 점액암이 갑자기 끝나는 종괴의 경계를 보이는 것이었다. 대부분의 점액암은 자기공명영상에서 불균일한 조영증강과 지연시 유실형 양상을 보였다.

Purpose : To examine the imaging findings of mucinous breast carcinoma and to evaluate the difference in these findings based on the histopathologic grade. Materials and Methods : We retrospectively analyzed the imaging features according to BI-RADS in 29 patients with surgically proven mucinous carcinoma. The histopathologic grade was classified as well-differentiated, moderately-differentiated and poorly-differentiated. Based on these criteria, the differences in imaging findings were statistically analyzed. Results : Mammography was available in 20 cases, which contained 17 mass lesions (85%) and 3 cases of normal findings. On ultrasonography (27 cases), mucinous carcinoma was observed as a mass with an oval shape (59.3%), a microlobulated margin (55.6%) or an inhomogeneous isoechogenicity (74.1%). On MRI (21 cases), mucinous carcinoma was commonly observed to have a lobular shape (76%), smooth margin (86%) or heterogeneous contrast-enhancement (61.9%). On the kinetic curve, there was a delayed wash-out pattern (52.3%). There were no significant differences in the imaging findings for each histopathologic grade except that a welldifferentiated tumor had an abrupt interface. Conclusion : A well-differentiated mucinous carcinoma tended to have an abrupt interface on ultrasonography, as compared with the moderately-differentiated one. Mucinous carcinoma showed a heterogeneous enhancement and a delayed washout kinetic curve pattern on dynamic MRI.

키워드

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