磁共振成像在非肿块型乳腺癌与肉芽肿性乳腺炎鉴别诊断中的应用价值  

The value of MRI in the differential diagnosis between non-mass breast cancer and granulomatous mastitis

作　　者：董向月 刘艳[1] DONG Xiangyue;LIU Yan(MR Room,the Affiliated Tumor Hos pital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院MR室,新疆乌鲁木齐830011

出　　处：《实用放射学杂志》2020年第6期909-911,964,共4页Journal of Practical Radiology

摘　　要：目的探讨MRI在非肿块型乳腺癌(NMBC)与肉芽肿性乳腺炎(GM)鉴别诊断中的应用价值。方法回顾性分析74例NMBC和68例GM的临床特征和MRI资料,所有患者均行术前MRI检查和术后病理活检。采用t检验比较2组病灶ADC值的差异,χ2检验比较2组病变强化特征和TIC类型的差异。结果74例NMBC以浸润性导管癌为主(63.5%),其内部强化特征以簇样环形强化为主,GM内部强化特征以均匀强化为主,差异有统计学意义(P<0.05)。NMBC的TIC多为Ⅱ型,GM的TIC多为Ⅰ型,差异有统计学意义(P<0.05)。2组ADC值分别为(1.09±0.44)×10-3 mm2/s和(1.36±0.42)×10-3 mm2/s,差异有统计学意义(P<0.05)。结论MRI动态增强联合DWI在诊断NMBC上具有一定的优势,可为临床诊断及鉴别诊断提供影像学参考。Objective To explore the value of MRI in the differential diagnosis between non-mass breast cancer(NMBC)and granulomatous mastitis(GM).Methods The clinical and MRI data of 74 cases with NMBC and 68 cases with GM were analyzed retrospectively.MRI examination and postoperative pathological biopsy were performed in all the patients.The ADC was compared by using t test,and the enhancement characteristics and TIC were compared by using chi-square test between the two groups.Results Invasive ductal carcinoma was accounted for the majority of 74 NMBC(63.5%).Most of the NMBC showed cluster ring enhancement,but GM mainly showed heterogeneous enhancement,which was significantly different in the internal enhancement between the two groups(P<0.05).TIC of the NMBC were mostly typeⅡ,and those of the GM were mostly typeⅠ,which was significantly different(P<0.05).ADC values of NMBC and GM were(1.09±0.44)×10-3 mm2/s and(1.36±0.42)×10-3 mm2/s,respectively,which was significantly different(P<0.05).Conclusion MRI dynamic contrast-enhancement combined with DWI is useful in the diagnosis of NMBC,and can provide imaging reference for clinical diagnosis and differential diagnosis.

关 键 词：非肿块型乳腺癌 肉芽肿性乳腺炎 磁共振成像 表观扩散系数 时间信号强度曲线 

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