慢性乳腺炎的综合影像学表现分析  

Comprehensive Imaging Findings of Chronic Mastitis

作　　者：程兰兰[1] 胡汉金[1] 吕王婧 汪飞 刘成成 CHENG Lan-lan;HU Han-jin;LV Wang-jing;WANG Fei;LIU Cheng-cheng(Department of Imaging,Anqing Municipal Hospital,Anqing 246001,Anhui Province,China;Department of Ultrasound Medicine,Anqing Municipal Hospital,Anqing 246001,AnhuiProvince,China)

机构地区：[1]安庆市立医院影像科,安徽安庆246001 [2]安庆市立医院超声医学科,安徽安庆246001

出　　处：《中国CT和MRI杂志》2022年第8期108-111,共4页Chinese Journal of CT and MRI

摘　　要：目的分析并总结慢性乳腺炎的X线、超声及MRI表现特征。方法回顾性收集2018年3月至2020年6月在安庆市立医院收治的经手术病理证实的60例慢性乳腺炎患者。55例术前行X线检查(52例行单纯FFDM检查,3例行FFDM联合DBT检查);53例术前行超声检查;13例术前行MRI检查。分析60例患者的X线、超声及MRI影像学表现。结果(1)临床及病理:60例患者,共61个病灶,其中左乳32个,右乳29个。慢性化脓性炎及肉芽肿性炎53例,肉芽肿性小叶炎5例,导管扩张症3例。(2)影像学表现:55例X线检查共发现56个病灶,其中非对称36例(36/56,64.3%);肿物9例(9/56,16.1%);结构扭曲9例(9/56,16.1%);单纯乳晕增厚2例(2/56,3.6%)。超声表现为低回声35例(35/53,66%);不均质回声11例(11/53,20.7%);肿块4例(4/53,7.5%);结构紊乱1例(1/53,1.9%);导管扩张1例(1/53,1.9%);阴性1例(1/53,1.9%)。MRI表现为肿块影7例(7/13,53.8%);非肿块影6例(6/13,46.2%)。MRI增强后有环形强化12例,液性区平均ADC值为0.87×10^(-3)mm^(2)/s。结论对于40岁以下育龄女性的乳房肿块患者,X线表现为非对称影或肿块,超声表现为不规则形的低回声,MRI上病灶边界不清、呈明显不均匀强化并伴有内壁光整的小环形强化、液性区ADC值较低时,可以有效提示慢性乳腺炎的诊断。Objective To analyze and summarize the X-ray,ultrasound and MRI features of chronic mastitis.Methods Retrospective collection of 60 patients with chronic mastitis confirmed by surgery and pathology admitted to Anqing Municipal Hospital from March 2018 to June 2020.Preoperative X-ray examination was performed in 55 patients(52 patients underwent FFDM alone,3 patients underwent FFDM combined with DBT).Preoperative ultrasonography was performed in 53 cases.13 cases underwent preoperation MRI examination.To analyze The X-ray,ultrasound and MRI imaging findings of 60 patients.Results(1)Clinical and pathological findings:there were 61 lesions in 60 patients,including 32 in the left breast and 29 in the right breast.There were 53 cases of chronic suppurative inflammation and granulomatous inflammation,5 cases of granulomatous lobulitis and 3 cases of ductal dilatation.(2)imaging fingings:A total of 56 lesions were found on X-ray examination in 55 cases.There were 36 cases(36/56,64.3%)with asymmetry on X-ray;mass in 9 cases(9/56,16.1%);structural distortion was observed in 9 patients(9/56,16.1%);simple areola thickening in 2 cases(2/56,3.6%).Echocardiography showed patchy or nodular hypoechogenicity in 35 cases(35/53,66%);Heterogenous echo in 11 cases(11/53,20.7%);4 cases of mass(4/53,7.5%);Structural disorder in 1 case(1/53,1.9%);Catheter dilatation in 1 case(1/53,1.9%);Negative 1 case(1/53,1.9%).MRI showed mass shadows in 7 cases(7/13,53.8%);Non-mass shadows were found in 6 patients(6/13,46.2%).DWI showed high signal.After MRI enhancement,the lesions were accompanied by ring enhancement in 12 cases,and the average ADC value in the fluid region was 0.87×10^(-3)mm^(2)/s.Conclusion For pre-menopausal women under the age of 40 patients with breast lumps,X-ray characterized by asymmetric shadow or lump,ultrasonic characterized by irregular shaped low anechoic,MRI lesions on the boundary is not clear,obvious uneven enhancement was accompanied by internal finishing small annular enhancement,fluid zone ADC values is low,can s

关 键 词：慢性乳腺炎 X线 超声 MRI成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]