目的 分析浸润性微乳头状癌的 MRI表现及临床病理特点。方法 回顾性分 析2013年1月至2016年5月期间，我院经手 术病理证实的21例浸润性微乳头状癌患者 的临床病理结果及MRI影像资料。结果 所 有病例均为乳腺浸润性导管癌，局部见浸 润性微乳头状癌，4例病灶合并导管原位 癌，1例并黏液癌，1例并神经内分泌分 化，1例伴有不典型增生，14例经病理证 实腋窝淋巴结转移，12例脉管内出现癌 栓。乳腺内病灶MRI强化方式表现为以肿 块样强化的病灶18个，病灶形态不规则， 边缘呈不规则或呈见毛刺，边缘强化较内 部强化明显，动态增强扫描病灶均早期明 显强化，时间-信号曲线(TIC)显示均为流 出型曲线；呈非肿块样强化病灶4例，分 布形态呈段样分布(2例)，呈区域分布(2 例)，病灶内部强化不均匀，TIC显示3例 流出型，1例平台型。MRI显示腋窝可疑转 移淋巴结17(21)例，12例病理证实为淋巴 结转移，诊断准确率达为70.5%。结论 乳 腺浸润性微乳头状癌具有独特的组织病理 学特征，MRI表现高度提示病变的恶性特 征及淋巴脉管转移特点。

Objective The purpose of this study is to present imaging findings of invasive micropapillary carcinoma(IMPC) with clinical and pathologic correlation. Methods MRI findings and pathologic types of IMPC in 21 patients were reviewed retrospectively in our institution from January 2012 to July 2016. MRI appearences were assessed using the American College of Radiology's BI-RADS lexicon. Results The histologic types of IMPC were invasive ductal carcinoma with micropapillary features, 4 cases combining with ductal carcinoma in situ(DCIS), 1 case with mucinous breast carcinoma, 1 case with neuroendocrine differentiation, 1 case with breast atypical hyperplasia, 14 cases with axillary lymph node metastases,and 12 cases with lymphovascular invasion.With MR, dynamic enhancement, 18 patients of breast masses presented mass enhancement, iregular shape, iregular or spiculated margin, the enhancement degrees of the masses edge was higher than that of the mass inner, all masses showed washout type of TIC. 4 patients of breast masses presented non-mass enhancement, 2 presented segmental distribution and 2 presented regional distribution with heterogeneous internal enchancement, and 3 washout and 1 plateau type of TIC. Accompaning signs included crater nipple(6 cases), skin thickening and front fascia pectoralis muscle pulled(11 cases). MRI showed 17 cases of suspicious lymph node metastasis, 12 cases of lymph node metastasis confirmed by pathology, the diagnostic accuracy rate was 70.5%. Conclusion IMPC is a distinct pathologic type of invasive ductal carcinoma. On MRI,the features of IMPC were highly suggestive of malignance associated with lymphovascular invasion and axillary lymph node metastases.