两种病理类型非哺乳期乳腺炎的超声影像表现
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摘要
目的应用超声BI-RADS分类分析非哺乳期乳腺炎的超声影像学表现,为临床诊断和鉴别诊断提供影像学依据。方法回顾性分析88例有明确病理结果的非哺乳期乳腺炎患者的术前超声检查结果,其中肉芽肿性小叶性乳腺炎(GLM)63例,浆细胞性乳腺炎(PCM)25例。比较两者的超声BI-RADS分类及声像图表现。结果 88例慢性乳腺炎患者共累及90个乳房,术前乳腺病变超声BI-RADS分类均为4类。GLM好发于乳腺外周,40%(26/65)病灶表现为实质回声不均匀减低,33.8%(22/65)为不均匀低回声包块,15.4%(10/65)为低回声结节,4.6%(3/65)为脓肿型,6.2%(4/65)为混合型。PCM好发于乳晕区,44%(11/25)表现为实质回声不均匀减低,20%(5/25)为囊实混合性,36%(9/25)为实性肿块。周围脂肪组织回声增强更常见于GLM。结论两种类型的非哺乳期乳腺炎超声声像图表现相似,GLM更好发于乳腺外周,常表现为实质回声不均匀减低,伴有周围脂肪组织增强;PCM好发于乳晕区。超声检查能够在一定程度上对两种疾病进行鉴别。
Objective To analyze the ultrasound imaging features of non-lactation mastitis,and to provide evidences for clinical differential diagnosis.Methods Ultrasound findings of 88 patients who were diagnosed as non-lactation mastitis,including 63 granulomatous lobular mastitis(GLM)and 25 plasma cell mastitis(PCM)by pathology,were analyzed retrospectively.Results All the 88 patients′lesions were categorized as category 4.GLM were often found in peripheral part of breasts,40%(26/65)GLM were heterogeneous echo pattern,33.8%(22/65)were heterogeneous hypoechoic mass,15.4%(10/65)were hypoechoic nodule,4.6%(3/65)were abscess,and 6.2%(4/65)were mixed pattern.PCM were usually found in the areola area,44%(11/25)heterogeneous echo pattern,20%(5/25)were complex cystic and solid,36%(9/25)were solid mass.Increased echogenicity of fat tissue were more common in GLM than PCM.Conclusions The ultrasound imaging features of GLM and PCM were similar.Location and increased echogenicity of the surrounding fat tissue in GLM can help differential diagnosis.
Objective To analyze the ultrasound imaging features of non-lactation mastitis,and to provide evidences for clinical differential diagnosis.Methods Ultrasound findings of 88 patients who were diagnosed as non-lactation mastitis,including 63 granulomatous lobular mastitis(GLM)and 25 plasma cell mastitis(PCM)by pathology,were analyzed retrospectively.Results All the 88 patients′lesions were categorized as category 4.GLM were often found in peripheral part of breasts,40%(26/65)GLM were heterogeneous echo pattern,33.8%(22/65)were heterogeneous hypoechoic mass,15.4%(10/65)were hypoechoic nodule,4.6%(3/65)were abscess,and 6.2%(4/65)were mixed pattern.PCM were usually found in the areola area,44%(11/25)heterogeneous echo pattern,20%(5/25)were complex cystic and solid,36%(9/25)were solid mass.Increased echogenicity of fat tissue were more common in GLM than PCM.Conclusions The ultrasound imaging features of GLM and PCM were similar.Location and increased echogenicity of the surrounding fat tissue in GLM can help differential diagnosis.
引文
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[3]魏巍丽,陈志奎,何以敉,等.乳腺导管扩张症声像图特征及误诊分析[J].中国超声医学杂志,2013,29(12):1075-1078.
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[7]OZTEKIN P S,DURHAN G,NERCIS KOSAR P,et al.Imaging findings in patients with granulomatous mastitis[J].Iran J Radiol,2016,13(3):e33900.
[8]胡君,黄晓玲.213例浆细胞性乳腺炎的超声表现及漏误诊原因分析[J].重庆医科大学学报,2013,38(12):1526-1528.
[9]FAZZIO R T,SHAH S S,SANDHU N P,et al.Idiopathic granulomatous mastitis:imaging update and review[J].Insights Imaging,2016,7(4):531-539.
[10]黄丹凤,林礼务,何以敉,等.非特异度肉芽肿性乳腺炎声像图特征及误诊分析[J].中国超声医学杂志,2014,30(1):22-25.
[11]闵三旭.89例肉芽肿性乳腺炎的临床病理学特征分析[J/OL].中华乳腺病杂志:电子版,2013,3(7):15-19.
[12]黄文斌,薛德彬,主译.乳腺病理活检解读[M].北京:北京科学技术出版社,2010:33-37.
[2]ADLER D D,CARSON P L,RUBIN J M,et al.Doppler ultrasound color flow imaging in the study of breast cancer:preliminary findings[J].Ultrasound Med Biol,1990,16(6):553-559.
[3]魏巍丽,陈志奎,何以敉,等.乳腺导管扩张症声像图特征及误诊分析[J].中国超声医学杂志,2013,29(12):1075-1078.
[4]深圳市统计局.深圳市2010年第六次全国人口普查主要数据公报,2010.
[5]ZULFIQAR B,APPALANENI U,AHMED B,et al.Idiopathic granulomatous mastitis mimicking inflammatory breast carcinoma:What are the odds[J]?IDCases,2016,6:83-84.
[6]SRIPATHI S,AYACHIT A,BALA A,et al.Idiopathic granulomatous mastitis:a diagnostic dilemma for the breast radiologist[J].Insights Imaging,2016,7(4):523-529.
[7]OZTEKIN P S,DURHAN G,NERCIS KOSAR P,et al.Imaging findings in patients with granulomatous mastitis[J].Iran J Radiol,2016,13(3):e33900.
[8]胡君,黄晓玲.213例浆细胞性乳腺炎的超声表现及漏误诊原因分析[J].重庆医科大学学报,2013,38(12):1526-1528.
[9]FAZZIO R T,SHAH S S,SANDHU N P,et al.Idiopathic granulomatous mastitis:imaging update and review[J].Insights Imaging,2016,7(4):531-539.
[10]黄丹凤,林礼务,何以敉,等.非特异度肉芽肿性乳腺炎声像图特征及误诊分析[J].中国超声医学杂志,2014,30(1):22-25.
[11]闵三旭.89例肉芽肿性乳腺炎的临床病理学特征分析[J/OL].中华乳腺病杂志:电子版,2013,3(7):15-19.
[12]黄文斌,薛德彬,主译.乳腺病理活检解读[M].北京:北京科学技术出版社,2010:33-37.