囊性中性粒细胞性肉芽肿性乳腺炎超声分型、临床及病理特征  

Ultrasonic Classifications,Clinical Manifestations and Pathological Characteristics of Cystic Neutrophilic Granulomatous Mastitis

作　　者：刘晓娜[1] 郭鱼波 王雅婷 储开昀[1] 郭智勇 刘雪梅 LIU Xiaona;GUO Yubo;WANG Yating;CHU Kaiyun;GUO Zhiyong;LIU Xuemei(Department of Ultrasound,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;不详)

机构地区：[1]首都医科大学附属北京中医医院超声科,北京100010 [2]首都医科大学附属北京中医医院乳腺科,北京100010

出　　处：《中国医学影像学杂志》2024年第12期1243-1247,共5页Chinese Journal of Medical Imaging

基　　金：北京市属医院科研培育项目(PX2022043,PZ2022009);北京市中医药科技发展资金项目(BJZYYB-2023-25);首都医科大学2024年教育教学改革研究课题(2024JYY255,2024JYY256)。

摘　　要：目的 探讨囊性中性粒细胞性肉芽肿性乳腺炎(CNGM)不同超声分型与临床及病理特征。资料与方法 回顾性分析首都医科大学附属北京中医医院2020年1月—2024年9月经病理确诊为CNGM的女性患者131例共155个病灶,均行超声检查,分析其超声、临床及病理特征。结果 155个CNGM病灶超声分型:导管型48个、实性肿块型48个、弥漫型28个、脓肿型31个;临床病程分期:急性期108个、亚急性期31个、迁延期16个;病变范围:局限型109个、弥漫型46个。病理革兰染色阴性95个;阳性60个(38.71%),包括阳性杆菌11个、阴性杆菌23个、其他26个。超声分型与病变范围显著相关(χ^(2)=14.267,P=0.003),导管型和肿块型病变范围以局限型为主,弥漫型和脓肿型中病变范围弥漫型比率升高。60例革兰染色阳性组中,导管型最多(20例),其次是肿块型(17例)。结论 CNGM病灶超声分型导管型和肿块型多见于临床急性期,与病变范围密切相关。38.71%的CNGM病灶革兰染色阳性,病程急性期细菌感染率及检出率相对较高。超声分型对CNGM病程分期和病变范围诊断有重要参考价值。Purpose To analyze the different ultrasonic classifications,clinical and pathological characteristics of cystic neutrophilic granulomatous mastitis(CNGM).Materials and Methods A retrospective analysis was conducted on the ultrasonic images,clinical manifestations,and pathological characteristics of 155 CNGM lesions in 131 female patients pathologically diagnosed from January 2020 to September 2024 in Beijing Hospital of Traditional Chinese Medicine,Capital Medical University.Results According to the ultrasonic classification of 155 lesions,there were 48 ductal lesions,48 solid mass lesions,28 diffuse lesions and 31 abscess lesions.Based on the clinical course staging,there were 108 lesions in the acute stage,31 in the subacute stage and 16 in the prolonged stage.According to the lesion scope classification,there were 109 localized lesions and 46 diffuse lesions.Gram staining was negative in 95 lesions and positive in 60 lesions(38.71%).Among the positive lesions,there were 11 positive bacilli,23 negative bacilli and 26 others.There was a statistical correlation between the ultrasonic classification and the lesion scope(χ^(2)=14.267,P=0.003).The ductal and mass-type lesions in the ultrasonic classification were mainly localized,while the ratio of diffuse lesion scope increased in the diffuse and abscess types.Among the 60 Gram-positive cases,the ductal type had the highest proportion in the ultrasonic classification(20),followed by the mass-type(17).Conclusion The ductal and mass type in the ultrasonic classification of CNGM lesions are more common in the clinical acute stage,which is closely related to the lesion scope.The Gram staining positivity rate of CNGM is 38.71%,and the bacterial infection rate and detection rate are relatively high in the acute stage.Ultrasonic classification provide an important reference for the judgment of CNGM staging and lesion range.

关 键 词：囊性中性粒细胞性肉芽肿性乳腺炎 乳房 超声检查 分型 病理学 外科 女性 

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]