浆细胞性乳腺炎的MRI分期及临床特征分析  

MRI staging and clinical features analysis of plasma cell mastitis

作　　者：饶慧敏 苏志祥 吴红丽[1] 卢林 朱蓉蓉[1] 梁玉玉 RAO Huimin;SU Zhixiang;WU Hongli;LU Lin;ZHU Rongrong;LIANG Yuyu(Medical Imaging Center,People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院医学影像中心,宁夏银川750002

出　　处：《宁夏医学杂志》2022年第2期109-111,共3页Ningxia Medical Journal

基　　金：宁夏医学影像临床研究中心创新平台建设项目(2018DPG05006);宁夏回族自治区人民医院培育振兴科研项目(202113)。

摘　　要：目的探究浆细胞性乳腺炎的磁共振成像(MRI)表现、分期及鉴别诊断。方法回顾性分析87例经病理确诊的浆细胞性乳腺炎患者的MRI资料,观察病变位置、大小、累及范围、形态、边界、信号特点、液化情况、水肿范围、乳头是否内凹,测量强化区域的强化曲线、ADC值。结果在87例患者均为单侧,病变位于左侧58例,右侧29例;乳头内凹51例,乳晕区病变54例,局部皮肤受累增厚62例。磁共振平扫T1WI呈等稍低信号,T2WI各种信号均可见,弥散加权成像(DWI)呈稍高16例,高信号及局部高亮信号71例,增强扫描呈肿块样强化17例,非肿块样强化70例,其中2例环壁较薄,无法测量强化曲线及ADC值。TICⅠ型24例,Ⅱ56例,Ⅲ型5例。70例见增粗血管影。在85例可测量患者中ADC值范围为(0.92~1.65)×10^(-3) mm/s。依据MRI表现分期,炎症期17例,脓肿期50例,瘘管期4例,混合期16例。结论MRI可以全面显示浆细胞性乳腺炎的部位、范围、深度,对病变进行分型及鉴别诊断,为临床治疗方案的选择奠定基础。Objective To explore the MRI manifestations,staging and differential diagnosis of plasma cell mastitis.Methods The MRI data of 87 patients with plasma cell mastitis diagnosed by pathology were retrospectively analyzed,the location,size,involvement range,shape,boundary,signal characteristics,liquefaction,edema range and whether the nipple was concave were observed.The enhancement curve and ADC value of the enhancement area were measured.Results 87 patients were unilateral,the lesions were located on the left side in 58 cases and on the right side in 29 cases,51 cases with nipple concave,54 cases with areola lesions and 62 cases with local skin thickening.MRI plain scan showed equal or slightly low signal on T1WI,and various signals on T2WI were visible.DWI showed slightly high in 16 cases,71 cases with high signal and local highlight signal,17 cases with mass enhancement and 70 cases with non-mass enhancement,of which 2 cases had thin ring wall,and the enhancement curve and ADC value could not be measured.There were 24 cases of TIC type Ⅰ,56 cases of type Ⅱ,and 5 cases of type Ⅲ.Thickened vascular shadow was seen in 70 cases.The ADC value in 85 measurable patients ranged from 0.92×10^(-3) mm/s to 1.65×10^(-3) mm/s.According to MRI staging,there were 17 cases of mass stage,50 cases of abscess stage,4 cases of fistula stage,and 16 cases of mixed stage.Conclusion MRI can comprehensively display the location,scope,and depth of plasma cell mastitis,and classify and differentially diagnose the lesions.MRI can lay a foundation for the selection of clinical treatment.

关 键 词：浆细胞性乳腺炎 磁共振成像 分型 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]