MRI影像诊断在肉芽肿性乳腺炎中的临床应用价值  

The Clinical Value of MRI Imaging Diagnosis in Granulomatous Mastitis

作　　者：陈对梅[1] 汪洋[1] 黄德干 Chen Duimei;Wang Yang;Huang Degan(Department of Imaging,The Second Hospital of Guangdong Province,Guangzhou,Guangdong 510095)

机构地区：[1]广东省第二中医院放射科,广东广州510095

出　　处：《现代医用影像学》2023年第3期413-417,共5页Modern Medical Imageology

摘　　要：目的:探讨MRI影像诊断对肉芽肿性乳腺炎(GM)的临床应用价值。方法:选择2013年1月至2021年12月经病理证实的GM患者16例,回顾性分析其临床和MR资料。结果:病灶6例(占37.5%)局限于1个象限,10例(占62.5%)累及多个象限。增强扫描4例(占25%)呈肿块样强化,其中3例肿块中央伴脓肿形成;TIC曲线Ⅰ型1例,Ⅱ型2例,Ⅲ型1例。12例(占75%)呈非肿块样强化,包括线样分布1例,节段样分布2例,区域性及多区域性分布7例,弥漫性分布2例;内部强化方式以不均匀强化为主(占75%),其中2例不均匀强化内伴单个小环形强化,8例伴多发小环形强化,脓腔聚集时表现为“蜂窝样”强化,大部分环内壁清晰光整,部分环内壁不光整伴腔内线样分隔;TIC曲线Ⅰ型4例,Ⅱ型6例,Ⅲ型2例。DWI上病灶呈不同程度高信号,脓肿部分平均ADC值低于非脓肿部分平均ADC值(P<0.05)。伴随征象:病灶周围水肿,乳腺后脂肪间隙模糊,瘘管形成,病灶周围血管增多,同侧腋下淋巴结肿大。结论:GM的MRI表现具有一定的特征性,结合临床综合分析可提高诊断的准确性,但最终确诊仍需要病理活检。Objective:To explore the clinical value of MRI imaging diagnosis in granulomatous mastitis(CM).Methods:A total of 16 patients with GM who were pathologically confirmed from January 2013 to December 2021 were selected,and their clinical and MR date were retrospectively reviewed.Results:6 cases were located to one quadrant(37.5%),and 10 cases involved multiple quadrants(62.5%).GM showed mass-like enhancement in 4 cases on contrast enhanced MRI(25%),and abscess formation in the center of the mass in 3 cases;The time-signal intensity(TIC)curves of 4 cases presented as typeⅠ,Ⅱ and Ⅲ inl,2,and 1 case respectively.There were 12 cases of non mass enhancement(75%),of which there were linear distribution in 1 case,segmental distribution in 2 cases,regional and multi-regional distribution in 7 cases,and diffuse distribution in 2 cases;The internal enhancement characteristics was mainly inhomogeneous enhancement(75%),of which 2 cases with a single small ring enhancement and 8 cases of multiple small ring enhancement;The abscesses showed honeycomb-like enhancement when they acumulated,and most of the inner walls of the ring were clear and smooth,some of them were not smooth with line-like separation;The TIC curve was 4 cases of type Ⅰ,6 cases of type Ⅱ and2 cases of type Ⅲ.The DWI showed different degrees of high signal,and the average ADC values ofGM on abscess area was lower than that of non-abscess area,which was statistically significant(P<0.05).Accompanying sings:edema around the lesion,blurred fat space behind the breast,fistula formation,increased blood vessels around the lesion and enlarged axillary lymph nodes on the same side.Conclusion:The MRI findings of GM have certain characteristics,combined with clinical comprehensive analysis can improve the accuracy of diagnosis,but the final diagnosis still need pathological biopsy.

关 键 词：肉芽肿性乳腺炎 磁共振成像 脓肿 

分 类 号：R445.2[医药卫生—影像医学与核医学] R655.8[医药卫生—诊断学]