肉芽肿性乳腺炎的MRI灌注成像及其与非肿块型乳腺癌的鉴别  

MR Perfusion Imaging of Granulomatous Mastistis:Compared with No-Mass Breast Cancer

作　　者：刘碧华[1] 陈曌[2] 郑晓林[1] 李晏[1] 范宪淼[1] 

机构地区：[1]广东省东莞市人民医院放射科,523029 [2]南方医科大学南方医院影像中心,广州510515

出　　处：《临床放射学杂志》2016年第10期1495-1498,共4页Journal of Clinical Radiology

基　　金：东莞市科技重点项目(编号:201350715000688)

摘　　要：目的探讨肉芽肿性乳腺炎(GM)的MRI灌注成像表现及其与非肿块型乳腺癌的鉴别诊断特征。方法回顾性分析经病理证实的20例GM和23例非肿块型乳腺癌患者资料。所有患者均行乳腺MRI检查。采用卡方检验比较GM与非肿块型乳腺癌患者的时间-信号强度曲线(TIC)类型。用Wilcoxon检验比较病灶血流动力学参数,包括早期强化率和峰值强化率。P<0.05为差异具有统计学意义。结果 GM的TIC为Ⅰ或Ⅱ型,非肿块型乳腺癌的TIC多为Ⅱ或Ⅲ型,少数为Ⅰ型,两者间差异具有统计学意义。GM的早期强化率和最大强化率分别为1.119和2.023;非肿块型乳腺癌的早期强化率和最大强化率分别为0.901和1.614。GM和非肿块型乳腺癌的血流动力学参数间无显著性差异。结论 GM与非肿块型乳腺癌的诊断需要密切结合临床、其他影像检查及MRI形态特征进行综合判断,MRI灌注成像对GM和乳腺癌的鉴别有一定意义,但其血流动力学半定量参数有重叠,有待进一步研究。Objective To investigate the radiological features of granulomatous mastitis（ GM） in MR perfusion imaging and to differentiate it from the non-mass breast cancer in diagnosis. Methods 20 cases of GM and 23 cases of breast cancer confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study. MR imaging examined all of the patients preoperatively. Time-intensity curve（ TIC） types in the two groups were evaluated and analyzed by χ2test.Pharmacokinetic parameters of MR perfusion imaging were used to measure the outcome,including early-phase enhancement rate（ EER） and peak enhancement ratio（ Emax）. EER and Emaxin GM were 1. 119 and 2. 023. EER and Emaxin nonmass breast cancer were 0. 901 and 1. 614. The statistical differences of EER and Emaxbetween the two groups were calculated by using Wilcoxon test. Results The types of TIC were type Ⅰ and Ⅱ in GM group. The types of TIC were type Ⅱand Ⅲ,but minority was type Ⅰ in cancer group. There was statistical significance between GM and cancer group. No significant statistic differences between GM and cancer group were found in EER and Emax. Conclusion The diagnosis of GM and non-mass breast cancer must involve clinica findings,other imaging tests and MR morphological features. MR perfusion is useful in the differential diagnosis between GM and non-mass breast cancer but the MR pharmacokinetic parameters present overlapping results. Further research is needed.

关 键 词：肉芽肿性乳腺炎 非肿块型乳腺癌 灌注成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R655.8