肉芽肿性乳腺炎的MR表现分析  

The MR features of granulomatous mastitis

作　　者：陈敏[1] 董渭盈[2] 古凌静[1] 杜中立[1] 刘玉涛[1] 王艳萍[1] 毛俊[1] 

机构地区：[1]珠海市人民医院放射科暨南大学附属第三医院,广东珠海519000 [2]珠海市妇幼保健院妇产科

出　　处：《实用放射学杂志》2014年第5期774-777,共4页Journal of Practical Radiology

基　　金：珠海市2012年卫生局科研项目（2012097）。

摘　　要：目的：探讨肉芽肿性乳腺炎（GM）的 MR 表现特征,提高对该病的认识。方法回顾性分析11例病理证实为 GM 患者的临床资料和 MRI 表现。结果11例 GM 中 T2 WI 呈区域性及弥漫性高信号9例（81.82%）,以网状不均质改变为特征。增强扫描呈肿块样强化2例（18.18%）,呈非肿块样强化9例（81.82%）,非肿块样强化包括：弥漫性强化2例（18.18%）,区域性强化4例（36.36%）,多发区域性强化2例（18.18%）,局灶性强化1例（9.09%）。增强早期不均匀强化为特征,其中6例（54.55%）可见多发簇环状强化,增强晚期信号增高并趋于均匀。时间-信号强度曲线Ⅰ型7例（63.64%）,Ⅱ型3例（27.27%）,Ⅲ型1例（9.09%）。病变区域 ADC值（1.82±0.17）×10-3 mm2/s,与对侧正常腺体 ADC 值差异无统计学意义（t=1.766,P 〉0.05）。MRI 显示伴随表现包括乳房增大,皮肤增厚,病灶周围水肿,淋巴结增大。BI-RADS 分级包括3类1例（9.09%）、4a 类5例（45.45%）、4b 类2例（18.18%）、4c 类2例（18.18%）及5类1例（9.09%）,术前诊断误诊率为54.55%。结论 GM 的 MRI 表现形式多样,但有一定的特征。因其误诊率高,诊断需要结合临床综合分析。Objective To explore the MR features of granulomatous mastitis and to improve the diagnosis of the disease.Methods MR findings of 1 1 patients with granulomatous mastitis confirmed by pathology were retrospectively reviewed.Results Nine （81.82%）lesions showed regional or diffused hyperintensity on T2 WI with heterogeneous gridding features.2 （18.18%）lesions showed mass-like enhancement and 9 lesions showed non-mass-like enhancement.Of 9 （81.82%）lesions with non-mass-like en-hancement,the enhancement patterns included diffused in 2 （18.18%）cases,regional in 4 （36.36%）cases,multiple-regional in 2 （18.18%）cases,and focal in 1 （9.09%）case,respectively.All the lesions showed early heterogeneous enhancement,and clumped-ring enhancement was seen in 6 lesions.The signal intensity of the lesions was increased and more uniform in the later stage.The time-signal intensity curve was type I in 7（63.64%）cases,type II in 3 （27.27%）cases and type III in 1 （9.09%）case.The mean ADC value was （1.82±0.1 7）×10 -3 mm2/s,and there was no significant difference between lesions and normal regions （t=1.766, P 〉0.05）.Concomitant signs included barymastia,thickening of skin,edema surrounding the lesions,and axillary lymph node en-largement.The BI-RADS category was 3 degree in 1 （9.09%）case,4a degree in 5 （45.45%）cases,4b degree in 2 （18.18%）ca-ses,4c degree in 2 （18.18%）cases and 5 degree in 1 （9.09%）case.The misdiagnosis ratio was 54.55%.Conclusion Granuloma-tous mastitis has certain characteristic MR features.The misdiagnosis ratio of granulomatous mastitis is high.Therefore,clinical data should be referred when making diagnosis.

关 键 词：肉芽肿性乳腺炎 磁共振成像 

分 类 号：R655.8[医药卫生—外科学] R445.2[医药卫生—临床医学]