不同中医证型的肿块型肉芽肿性乳腺炎超声图像特征分析  

Ultrasound imaging features of different traditional Chinese medicine syndromes in mass-forming granulomatous mastitis

作　　者：孙景环[1] 董桂芳[2] 杨倩玫[2] SUN Jinghuan;DONG Guifang;YANG Qianmei(Department of Traditional Chinese Medicine,Chongqing Jiangjin District Traditional Chinese Medicine Hospital,Jiangjin Hospital,Chongqing University of Chinese Medicine,Chongqing 402260,China)

机构地区：[1]重庆市江津区中医院,重庆中医药学院附属江津医院中医科,重庆市402260 [2]重庆市中医院重庆中医药学院附属第一医院超声科

出　　处：《临床超声医学杂志》2024年第11期927-931,共5页Journal of Clinical Ultrasound in Medicine

基　　金：2021年重庆市科研机构绩效激励引导专项项目(jxyn2021-2-8);2022年重庆市教育委员会科学技术研究项目(KJQN202215117);2022年重庆市科卫联合医学科研项目(2022MSXM189);重庆市中医院第三批青年拔尖人才项目(CQSZYY2022009)。

摘　　要：目的 分析不同中医证型的肿块型肉芽肿性乳腺炎(GM)常规超声及平面波超敏感血流成像(AP)图像特征,探讨中医证型与其超声分型的相关性。方法 选取我院经穿刺活检病理确诊的肿块型GM患者80例,其中气滞热壅证组45例,阳虚痰凝证组35例,比较两组二维超声及AP图像特征;分析中医证型与超声分型的相关性。结果 气滞热壅证组病灶多表现为形态不规则(71.11%)、边缘不光整(64.44%)、超声分型以混合回声型为主(66.67%),AP血流分级多为Ⅱ~Ⅲ级(80.00%);阳虚痰凝证组病灶多表现为形态规则(60.00%)、边缘光整(60.00%)、超声分型以不均质结节型为主(60%),AP血流分级多为Ⅰ级(54.29%),两组比较差异均有统计学意义(均P<0.05)。中医证型与超声分型有一定的相关性(Cramer’s V系数=0.526,P<0.001)。结论 肿块型GM的中医证型与其超声分型相关;超声可为肿块型GM的中医辨证论治提供一定的影像学依据。Objective To analyze the conventional ultrasound and angio plus planewave ultrasensitive imaging(AP)features of mass-forming granulomatous mastitis(GM)in different traditional Chinese medicine(TCM)syndromes,and to explore the correlation between TCM syndromes and ultrasound types.Methods A total of 80 patients with pathologically confirmed mass-forming GM by core needle biopsy were selected,with 45 cases in the Qi Stagnation and Heat Obstruction group and 35 cases in the Yang Deficiency with Phlegm Accumulation group.The two-dimensional ultrasound and AP features were compared between the two groups,and the correlation between TCM syndromes and ultrasound types was analyzed.Results In the Qi Stagnation and Heat Obstruction group,lesions mostly presented with irregular shapes(71.11%),unclear margins(64.44%),and were primarily of mixed echo type on ultrasound(66.67%),with AP blood flow grading mostly wasⅡ~Ⅲ(80.00%).In the Yang Deficiency with Phlegm Accumulation group,lesions mostly presented with regular shapes(60.00%),clear margins(60.00%),and were primarily of heterogeneous nodular type on ultrasound(60.00%),with AP blood flow grading mostly wasⅠ(54.29%).The differences between the two groups were statistically significant(all P<0.05).There were a certain correlation between TCM syndromes and ultrasound types(Cramer’s V coefficient=0.526,P<0.001).Conclusion There is a certain correlation between TCM syndromes and ultrasound types,and ultrasound can provide imaging evidence to support the TCM-based syndrome differentiation and treatment of mass-forming GM.

关 键 词：超声检查 平面波超敏感血流成像 肉芽肿性乳腺炎 肿块型 中医证型 

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]