非特异性肉芽肿性乳腺炎声像图特征及误诊分析  

Nonspecific granuloma mastitis ultrasonographic features and misdiagnosis analysis

作　　者：程静 唐利 张灿晶 白兰平 张晓明 

机构地区：[1]重庆市东南医院超声科,401336

出　　处：《检验医学与临床》2015年第2期186-187,190,共3页Laboratory Medicine and Clinic

摘　　要：目的研究非特异性肉芽肿性乳腺炎(NGM)患者超声声像图特征以及临床误诊的原因,以此来提升临床对特异性肉芽肿性乳腺炎的诊断阳性率。方法选择2011年1月至2013年1月诊治的52例经过手术病理证实为非特异性肉芽肿性乳腺炎的超声声像图表现,对其临床资料进行分析,研究其声像图特征以及超声分型,总结其出现误诊的原因。结果非特异性肉芽肿性乳腺炎的声像图表现为3型,具体为团块、结节以及窦道管样等,其中76.9%为团块型和结节型,上述两种类型肿块边缘主要表现为蟹足征或者毛刺征,最高可达到61.5%,其中55.0%患者具有特征性表现,病灶内可见管状无回声或者小囊状无回声。23.0%的患者为窦道管样型,患者主要表现为管状低回声或者与皮肤相通的窦道。所选的患者实施超声检查与病理符合率仅仅达到30.8%,有一半被误诊为乳腺癌,尤其是窦道管样型超声容易被误诊为导管癌或者导管内瘤样变。结论对非特异性肉芽肿性乳腺炎声像图的特征进行分析,具有一定的特征性表现,再结合临床资料进行判断,能够有效提升超声诊断以及鉴别诊断水平,对临床诊断和治疗均具有显著的临床意义。Objective To study the ultrasonographic features of nonspecific granuloma mastitis （NGM ） and the reasons for its clinical misdiagnosis in order to enhance the diagnostic positive rate of NGM in clinic .Methods 52 cases of operatively and pathologically confirmed NGM in our hospital from January 2011 to January 2013 were se‐lected and their clinical data were analyzed for researching the ultrasonographic features and the ultrasonic types .The reasons leading to misdiagnosis were summarized .Results The NGM ultrasonograms showed three types ,specifical‐ly clumps ,nodules and sinus tract tube‐like ,76 .9% of which was mass and nodular types ,their edges were mainly manifested by crab foot sign or burr sign ,which was highest up to 61 .5% ,55 .0% of which possessed the character‐istic manifestations ,the tubular echoless or small cystic echoless were seen in the lesions .23 .0% of the patients were sinus tract tube‐like type ,which was mainly manifested by the tubular hypoecho or sinus communicating with the skin .The coincidence rate of ultrasonographic examination and the pathological examination in the selected patients reached only 30 .8% ,half being misdiagnosed as breast cancer ,especially the sinus tract tube‐like ultrasonogram could be easily to be misdiagnosed as ducal carcinoma or intraductal tumor‐like change .Conclusion The analysis on the characteristics of NGM shows that NGM has a certain characteristic manifestations ,by combining with the clinical data for conducting the judgment ,which can effectively enhance the level of the ultrasound diagnosis and differential diagnosis and has the important clinical significance for the clinical diagnosis and treatment .

关 键 词：非特异性肉芽肿 乳腺炎 超声声像图 误诊分析 

分 类 号：R655.8[医药卫生—外科学]