超声对不同类型非哺乳期乳腺炎的鉴别诊断及声像图特征  

Ultrasonography in Differential Diagnosis of Different Types of Non-Puerperal Mastitis and Analysis of Sonographic Features

作　　者：马青 朱阳阳 贾英英[1] 李振东 王芙蓉[2] 聂芳[1] MA Qing;ZHU Yangyang;JIA Yingying;LI Zhendong;WANG Furong;NIE Fang(Ultrasonic Medical Center,the Second Hospital&Clinical Medical School,Lanzhou University,Lanzhou 730030,China;不详)

机构地区：[1]兰州大学第二医院(第二临床医学院)超声医学中心,甘肃兰州730030 [2]兰州大学第二医院(第二临床医学院)病理科,甘肃兰州730030

出　　处：《中国医学影像学杂志》2024年第5期468-472,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨超声鉴别导管周围乳腺炎(PDM)和肉芽肿性小叶乳腺炎(GLM)的价值,总结非哺乳期乳腺炎(NPM)的声像图特征。资料与方法回顾性分析2016年7月—2021年6月在兰州大学第二医院接受治疗的134例NPM(84例PDM,50例GLM)患者的超声表现,比较PDM和GLM声像图表现(病灶数量、病灶侧别、病灶方位、距乳头距离、长径、厚径、纵横比、边界、边缘、外形、内部回声、周边高回声晕、后方回声、钙化、内部血流、同侧腋窝淋巴结增大)的差异,并根据病灶形态及内部回声情况总结NPM的声像图特征。结果PDM与GLM声像图表现相似,差异无统计学意义(P>0.05)。PDM合并同侧腋窝淋巴结增大的概率略高于GLM(χ^(2)=4.209,P=0.040);134例NPM病变的声像图根据形态及回声改变情况分为7种类型,脓肿型在GLM中更多见(χ^(2)=4.928,P=0.026)。结论PDM与GLM的声像图表现无显著差异。在临床及影像学无法区分PDM与GLM的情况下,治疗前进行穿刺活检明确病理类型再进行治疗可能更有利于患者获得最佳预后。将NPM分为7种类型有助于超声医师掌握NPM的声像图特征,从而进行早期诊断。Purpose To explore the value of ultrasonography in distinguishing periductal mastitis(PDM)from granulomatous lobular mastitis(GLM)and summarize the sonographic features of non-puerperal mastitis(NPM).Materials and Methods The ultrasonographic findings of 134 NPM(84 PDM,50 GLM)patients treated in the Second Hospital of Lanzhou University from July 2016 to June 2021 were retrospectively analyzed.Comparing PDM and GLM sonograms,the difference of lesion number,lesion side,lesion orientation,distance from the nipple,long diameter,thick diameter,aspect ratio,boundary,edge,edge,shape,internal echo,peripheral high echo halo,rear echo,calcification,internal blood flow,ipsilateral axillary lymph node enlargement,and summarize the characteristics of NPM according to the lesion morphology and internal echo.Results There was no statistical difference between PDM and GLM(P>0.05).But the probability of PDM combined with ipsilateral axillary lymph node enlargement was slightly higher than that of GLM(χ^(2)=4.209,P=0.040).The ultrasonography of 134 cases of NPM lesions was divided into 7 types according to the morphology and echo changes.The abscess type was more common in GLM than in PDM(χ^(2)=4.928,P=0.026).Conclusion There is no significant difference between PDM and GLM.In the case that PDM and GLM cannot be distinguished clinically and radiologically,it is recommended to perform puncture biopsy to determine the pathological type before treatment,which may be more conducive to obtaining the best prognosis for patients.In addition,the classification of NPM into 7 types is helpful for sonographers to grasp the ultrasonographic characteristics of NPM to diagnose NPM early.

关 键 词：乳腺炎 肉芽肿性乳腺炎 超声检查 诊断 鉴别 

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]