非肿块性肉芽肿性乳腺炎的MRI表现及其与非肿块样强化乳腺导管原位癌的鉴别  

Analysis of MRI Manifestation of Non-mass Granulomatous Mastitis and Differentiating from Non-mass Enhancement Ductal Carcinoma in Situ

作　　者：陈艳 崔利 何江波 吴晓燕[2] 彭雨彬 郭宝聪 刘立红 Chen Yan;Cui Li;He Jiangbo(Department of Radiology,Baoshan District Chinese Traditional and Western Medicine Hospital,Shanghai 201900,China)

机构地区：[1]上海市宝山区中西医结合医院放射科,201900 [2]上海中医药大学附属曙光医院放射科,201203

出　　处：《医学研究杂志》2018年第10期157-161,165,共6页Journal of Medical Research

摘　　要：目的探讨非肿块性肉芽肿性乳腺炎(GM)的MRI表现,并与非肿块样强化乳腺导管原位癌(DCIS)鉴别,以提高二者的诊断水平。方法回顾性分析24例非肿块性GM的MRI表现,并与22例非肿块样强化DCIS的MRI表现进行比较。结果非肿块性GM与非肿块样强化DCIS均可表现为边界不清,呈节段性强化,与DCIS患者比较,GM患者病灶形态多为不均匀强化伴多发环形强化、毛刺征少,乳头内陷比例、ADC值明显升高(P <0. 05);GM患者时间-信号强度曲线(TIC)以Ⅰ、Ⅱ型多见,DCIS以Ⅱ、Ⅲ型多见,分别占87. 5%、81. 8%,差异无统计学意义(P>0. 05)。结论非肿块性GM与非肿块样强化DCIS在影像学表现方面存在一定相似之处,而多发环形强化、毛刺征、乳头内陷等形态学特征,有助于非肿块性GM与非肿块样强化DCIS的鉴别诊断。Objective To investigate the MRI manifestation of non-mass granulomatous mastitis(GM)and differentiating from non-mass enhancement ductal carcinoma in situ(DCIS)so as to improve diagnostic accuracy of GM and DCIS.Methods The MRI manifestation of 24 patients with non-mass GM were analyzed,and compared with the MRI manifestations of 20 cases of non-mass enhancement DCIS.Results Non-mass GM and non-mass enhancement DCIS were both characterized by unclear boundary and segmental reinforcement.Compared with DCIS patients,the lesions morphology of GM patients mostly were inhomogeneous enhancement combined with multiple ring reinforcement,and less spiculation sign,higher proportion of nipple retraction.ADC values was increased significantly(P<0.05).The time-signal intensity curve(TIC)in GM patients was common in typeⅠ,Ⅱ,typeⅡ,Ⅲin DCIS,accounted for 87.5%and 81.8%respectively.There was no significant difference(P>0.05).Conclusion There are some similarities in terms of imaging manifestations between non-mass GM and non-mass enhancement DCIS,while morphology feature of multiple ring reinforcement,spiculation sign,nipple retraction can help the differential diagnosis of non-mass GM and non-mass enhancement DCIS.

关 键 词：非肿块性肉芽肿性乳腺炎 非肿块样强化乳腺导管原位癌 MRI 鉴别诊断 

分 类 号：R81[医药卫生—放射医学] R737.9[医药卫生—临床医学]