肉芽肿小叶性乳腺炎的临床特点及CDFI评分与BI-RADS分级在诊断中的应用价值  

The Clinical Characteristics of Granulomatous Lobular Mastitis and the Application Value of BI-RADS Lexicon and CDFI Scoring in Ultrasonic Diagnosis

作　　者：曹云云[1] 王慧[1] 王冠杰 陈薇[1] 龚晓萍 Cao Yunyun;Wang Hui;Wang Guanjie;Chen Wei;Gong Xiaoping(The International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai,Shanghai Key Laboratory of Embryo Original Diseases,Shanghai,Shanghai Municipal Key Clinical Specialty,Shanghai,200030,China)

机构地区：[1]上海交通大学附属国际和平妇幼保健院,上海市胚胎源性疾病重点实验室,上海市临床重点专科建设项目-“强主体”妇产科,上海市200030

出　　处：《中国超声医学杂志》2021年第7期756-760,共5页Chinese Journal of Ultrasound in Medicine

基　　金：上海市卫生与计划生育委员会青年课题(No.20184Y0317)。

摘　　要：目的探讨肉芽肿小叶性乳腺炎(GLM)的临床特点及超声在诊断中的价值。方法回顾性分析86例经确诊为GLM患者的临床资料及超声表现,并进行CDFI评分和BI-RADS超声分级比较。结果 (1)育龄期患者98.8%,以无痛性肿块就诊47.7%,单侧发病97.6%,外上象限最多占38.4%。(2)病灶91.7%呈不规则形,70.9%边界不光整,纵横比均<1;64%呈低回声,混合回声34.9%,30.2%伴窦道形成;96.5%为无钙化或粗钙化,94.2%后方回声多无变化或增强;病灶内部探及血流信号77.9%,以低阻为主<0.7(72.1%)。(3)CDFI评分诊断GLM的价值优于BI-RADS分级,差别有统计学意义(P=0.001 8)。结论 GLM的临床特点及超声图像均缺乏特异度,但结合两者考虑,有利于提高对该疾病的诊断和鉴别诊断;在GLM诊断中CDFI评分优于BI-RADS分级,更有利于指导临床对该疾病的正确判断和治疗。Objective To investigate the clinical characteristics of granulomatous lobular mastitis(GLM) and the value of ultrasound in its diagnosis. Methods The 86 patients with GLM were confirmed and the clinical data and ultrasonographic features were analyzed retrospectively. The lesions were compared with BI-RADS lexicon and color doppler flow imaging. Results(1)The patients were childbearing age(98.8%). The patient saw a doctor with a painless mass(47.7%). The cases were unilateral(97.6%), and the outer upper quadrant accounts(38.4%).(2)The lesions were irregular(91.7%), not circumscribed(70.9%) and the aspect ratio was all less than 1. The lesions were hyoechoic(64%) and mixed echo(34.9%), meanwhile they were associated with sinus formation(30.2%).The lesions were no calcification or coarse calcification(96.5%), no posterior acoustic features or enhancement(94.2%). Intra-lesion blood flow signals could be detected(77.9%), and the blood flow resistance index was mainly low resistance(72.1%).(3)There were statistically significant differences between CDFI scoring and BI-RADS lexicon, and the former was better than the latter in diagnosis of GML. Conclusions The clinical features and ultrasonoscopy of GLM are lack of specificity, however, both of the close combination can help to improve the diagnosis and differential diagnosis. CDFI scoring is better than BI-RADS lexicon in diagnosis of GML, which is more conducive to guiding clinicians to correctly judge and actively treat the disease.

关 键 词：乳腺 超声 CDFI GLM 

分 类 号：R445.1[医药卫生—影像医学与核医学] R655.8[医药卫生—诊断学]