常规超声联合实时组织弹性成像对特发性肉芽肿性乳腺炎的诊断价值分析  

Diagnostic Value of Conventional Ultrasonography Combined with Real-time Tissue Elastography for the Diagnosis of Idiopathic Granulomatous Mastitis

作　　者：黄春旺[1] 裴书芳[1] 王银[1] 李妙珊[1] 赵晓虹[1] 

机构地区：[1]广东省人民医院,广东省医学科学院超声科,广东省广州市510080

出　　处：《中国全科医学》2014年第30期3649-3651,共3页Chinese General Practice

摘　　要：目的探讨常规超声联合实时组织弹性成像（RTE）对特发性肉芽肿性乳腺炎（IGM）的诊断价值。方法收集2011年1月—2014年1月于广东省人民医院经手术病理证实的34例IGM患者的相关临床资料,分析其常规超声声像图特征、超声弹性成像评分和应变率比值（B/A）结果。结果 IGM常规超声声像图：管样型13例,团块型18例,弥漫型3例,内可及管状低回声,边缘成角多圆钝,8例病灶内探及液性无回声区,7例出现＂假肾征＂,20例伴有同侧腋窝淋巴结肿大;彩色多普勒血流显像（CDFI）示血供0级4例,Ⅰ级18例,Ⅱ级8例,Ⅲ级4例,血管走行自然,多位于病灶边缘或与病灶表面平行,中心血供稀疏;收缩期峰值流速（PSV）6~19 cm/s,阻力指数（RI）0.53~0.82,平均（0.70±0.11）。RTE：29个IGM病灶评分≤3分,5个IGM病灶评分≥4分;31个IGM病灶B/A〈3.08,3个IGM病灶B/A≥3.08,平均值为（2.29±0.38）。结论 IGM的常规超声声像图具有一定特征,而超声弹性成像评分法和B/A测量技术在乳腺良恶性病灶的鉴别诊断中有较高价值,联合二者有助于提高IGM的术前诊断准确率。Objective To explore the diagnostic value of conventional ultrasonography combined with real-time tissue elastography（ RTE） for the idiopathic granulomatous mastitis（ IGM）. Methods Data of 34 cases of IGM confirmed by surgical pathology in Guangdong General Hospital from January 2011 to January 2014 were collected,and the conventional ultrasonic ultrasonographic features,ultrasound elasticity imaging score and result of the B /A were analyzed. Results There were three types of IGM in conventional ultrasonic： 13 cases were tube types,18 cases were mass types,3 cases were diffuse types,which featured in low echo,and the edge angle was more obtuse. There was liquidity anechoic area in 8 cases, ＂ pseudo- kidney sign＂ in7 cases,and ipsilateral axillary lymph node enlargement in 20 cases. CDFI showed that 4 cases were 0 class of blood supplying,18 cases were Ⅰ class,8 cases were Ⅱ class,and 4 cases were Ⅲ class,and the blood vessels ran naturally,which were located in the margin of the lesion or parallel with the focal surface,lacking blood supplying in the central area; PSV 6- 19 cm /s,RI 0. 53- 0. 82（ average 0. 70 ± 0. 11）. RTE： 29 cases of IGM lesion scores were≤3,5 cases of lesion scores were ≥4,and the B /A in 31 cases of IGM lesion were 3. 08,3 cases were ≥3. 08,and the average value were（ 2. 29 ± 0. 38）. Conclusion Conventional ultrasonography of IGM has certain characteristics,and ultrasonic elasticity imaging and the B /A measurement technology have a higher value in the differential diagnosis of benign and malignant breast lesions. It will be helpful to improve the preoperative ultrasound diagnostic accuracy for IGM by combining the two methods.

关 键 词：超声检查 肉芽肿 乳腺肿瘤 实时组织弹性成像 弹性应变率比值 

分 类 号：R739.41[医药卫生—肿瘤]