重视MRI在非哺乳期乳腺炎诊疗中的应用
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摘要
近年来,非哺乳期乳腺炎的发病率逐渐增高,其临床体征及影像学表现均与乳腺癌相似,极易混淆。MRI具有极好的软组织分辨率和无辐射特点,临床上主要用于乳腺癌的诊断与鉴别诊断,而在非哺乳期乳腺炎诊疗中的应用较少。笔者通过分析MRI在非哺乳期乳腺炎诊断、分类、治疗与疗效监测等方面的价值,以期重视MRI在非哺乳期乳腺炎诊疗中的应用,提高非哺乳期乳腺炎的术前诊断率,减少误诊。
In recent years,the incidence of non-puerperal mastitis has been increasing gradually. Its clinical and radiological findings are similar to those of breast cancer,which can be confused easily. MRI has the advantages of excellent soft tissue resolution and no radiation,mainly used in the diagnosis and differential diagnosis of breast cancer. However,MRI is not widely applied in non-puerperal mastitis. In this study,we investigated the value of MRI in the diagnosis,classification,treatment and efficacy monitoring of nonpuerperal mastitis in order to improve the awareness of clinicians in the diagnosis and treatment,increase the accuracy of diagnosis and reduce the misdiagnosis rate.
In recent years,the incidence of non-puerperal mastitis has been increasing gradually. Its clinical and radiological findings are similar to those of breast cancer,which can be confused easily. MRI has the advantages of excellent soft tissue resolution and no radiation,mainly used in the diagnosis and differential diagnosis of breast cancer. However,MRI is not widely applied in non-puerperal mastitis. In this study,we investigated the value of MRI in the diagnosis,classification,treatment and efficacy monitoring of nonpuerperal mastitis in order to improve the awareness of clinicians in the diagnosis and treatment,increase the accuracy of diagnosis and reduce the misdiagnosis rate.
引文
[1]杨剑敏,王颀,张安秦,等.导管周围乳腺炎与肉芽肿性乳腺炎的临床鉴别与处理[J/CD].中华乳腺病杂志(电子版),2011,5(3):306-312.
[2]Tan H,Li R,Peng W,et al.Radiological and clinical features of adult non-puerperal mastitis[J].Br J Radiol,2013,86(1024):221-225.
[3]汪登斌.乳腺导管原位癌的影像学研究[J].磁共振成像,2012,3(2):109-113.
[4]Riedl CC,Luft N,Bernhart C,et al.Triple-modality screening trial for familial breast cancer underlines the importance of magnetic resonance imaging and questions the role of mammography and ultrasound regardless of patient mutation status,age,and breast density[J].J Clin Oncol,2015,33(10):1128-1135.
[5]Kuhl CK,Schrading S,Strobel K,et al.Abbreviated breast magnetic resonance imaging(MRI):first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI[J].J Clin Oncol,2014,32(22):2304-2310.
[6]孙东方,谭红娜,彭卫军,等.非产后期乳腺炎的MRI表现分析[J].放射学实践,2011,26(11):1176-1179.
[7]Liu H,Peng W.Morphological manifestations of nonpuerperal mastitis on magnetic resonance imaging[J].J Magn Reson Imaging,2011,33(6):1369-1374.
[8]Wang L,Wang D,Fei X,et al.A rim-enhanced mass with central cystic changes on MR imaging:how to distinguish breast cancer from inflammatory breast diseases?[J].PLo S One,2014,9(3):e90355.
[9]周长玉,许茂盛,喻迎星,等.肉芽肿性乳腺炎的动态增强MRI和扩散加权成像表现及其与乳腺癌的鉴别[J].中华放射学杂志,2014,48(2):1000-1004.
[10]Aslan S,Pourbagher A,Colakoglu T.Idiopathic granulomatous mastitis:magnetic resonance imaging findings with diffusion MRI[J].Acta Radiol,2016,57(7):796-801.
[11]范光荣,陈翠芬,朱志军,等.磁共振表观扩散系数对非哺乳期乳腺炎和乳腺癌的鉴别诊断价值[J].临床放射学杂志,2015,34(4):544-547.
[12]何劲松.非哺乳期乳腺炎的临床特征及诊疗进展[J].罕少疾病杂志,2015,22(2):10-11.
[13]王颀.应重视非哺乳期乳腺炎的诊治和研究[J/CD].中华乳腺病杂志(电子版),2013,7(3):154-156.
[14]费正华,罗志琴,李志,等.磁共振动态增强和弥散加权成像在不同类型乳腺炎性疾病诊断与鉴别诊断的应用价值[J].中华医院感染学杂志,2017,27(3):628-631.
[15]孟金丽.磁共振动态增强联合弥散加权成像对乳腺炎性疾病的诊断价值研究[D].大连:大连医科大学,2015.
[16]谭文莉,陆孟莹,黄学菁,等.MRI在浆细胞性乳腺炎分期中的价值[J].临床放射学杂志,2011,30(4):492-495.
[17]刘佩芳.浆细胞性乳腺炎和肉芽肿性乳腺炎的影像学诊断及鉴别诊断[J].国际医学放射性杂志,2009,32(3):268-273.
[18]Gautier N,Lalonde L,Tran-Thanh D,et al.Chronic granulomatous mastitis:imaging,pathology and management[J].Eur Radiol,2013,82(4):165-175.
[19]曾献军,段文锋,方磊,等.乳腺结核的临床及MRI特点[J].中华放射学杂志,2011,45(12):1220-1222.
[20]赵秋枫,李琼,王永灵,等.浆细胞性乳腺炎的MRI表现及手术对照研究[J].肿瘤影像学,2013,22(2):107-111.
[21]张超杰,范培芝,刘鹏,等.动态磁共振成像在肉芽肿性乳腺炎手术评估中的应用价值[J].中国现代医学杂志,2012,22(21):86-89.
[22]王永灵,赵秋枫,李琼,等.浆细胞性乳腺炎MRI部位分型与手术方案选择的临床研究[J].中国中西医结合影像学杂志,2015,13(6):598-603.
[23]Frei KA,Kinkel K,Bone1 HM,et al.MR imaging of the breast in patients with positive margins after lumpectomy:influence of the time interval between lumpectomy and MR imaging[J].AJR Am J Roentgenol,2000,175(6):1577-1584.
[24]周纯武,张仁知.MRI随访在乳腺癌诊断和疗效评估中的价值[J].磁共振成像,2011,2(3):166-171.
[2]Tan H,Li R,Peng W,et al.Radiological and clinical features of adult non-puerperal mastitis[J].Br J Radiol,2013,86(1024):221-225.
[3]汪登斌.乳腺导管原位癌的影像学研究[J].磁共振成像,2012,3(2):109-113.
[4]Riedl CC,Luft N,Bernhart C,et al.Triple-modality screening trial for familial breast cancer underlines the importance of magnetic resonance imaging and questions the role of mammography and ultrasound regardless of patient mutation status,age,and breast density[J].J Clin Oncol,2015,33(10):1128-1135.
[5]Kuhl CK,Schrading S,Strobel K,et al.Abbreviated breast magnetic resonance imaging(MRI):first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI[J].J Clin Oncol,2014,32(22):2304-2310.
[6]孙东方,谭红娜,彭卫军,等.非产后期乳腺炎的MRI表现分析[J].放射学实践,2011,26(11):1176-1179.
[7]Liu H,Peng W.Morphological manifestations of nonpuerperal mastitis on magnetic resonance imaging[J].J Magn Reson Imaging,2011,33(6):1369-1374.
[8]Wang L,Wang D,Fei X,et al.A rim-enhanced mass with central cystic changes on MR imaging:how to distinguish breast cancer from inflammatory breast diseases?[J].PLo S One,2014,9(3):e90355.
[9]周长玉,许茂盛,喻迎星,等.肉芽肿性乳腺炎的动态增强MRI和扩散加权成像表现及其与乳腺癌的鉴别[J].中华放射学杂志,2014,48(2):1000-1004.
[10]Aslan S,Pourbagher A,Colakoglu T.Idiopathic granulomatous mastitis:magnetic resonance imaging findings with diffusion MRI[J].Acta Radiol,2016,57(7):796-801.
[11]范光荣,陈翠芬,朱志军,等.磁共振表观扩散系数对非哺乳期乳腺炎和乳腺癌的鉴别诊断价值[J].临床放射学杂志,2015,34(4):544-547.
[12]何劲松.非哺乳期乳腺炎的临床特征及诊疗进展[J].罕少疾病杂志,2015,22(2):10-11.
[13]王颀.应重视非哺乳期乳腺炎的诊治和研究[J/CD].中华乳腺病杂志(电子版),2013,7(3):154-156.
[14]费正华,罗志琴,李志,等.磁共振动态增强和弥散加权成像在不同类型乳腺炎性疾病诊断与鉴别诊断的应用价值[J].中华医院感染学杂志,2017,27(3):628-631.
[15]孟金丽.磁共振动态增强联合弥散加权成像对乳腺炎性疾病的诊断价值研究[D].大连:大连医科大学,2015.
[16]谭文莉,陆孟莹,黄学菁,等.MRI在浆细胞性乳腺炎分期中的价值[J].临床放射学杂志,2011,30(4):492-495.
[17]刘佩芳.浆细胞性乳腺炎和肉芽肿性乳腺炎的影像学诊断及鉴别诊断[J].国际医学放射性杂志,2009,32(3):268-273.
[18]Gautier N,Lalonde L,Tran-Thanh D,et al.Chronic granulomatous mastitis:imaging,pathology and management[J].Eur Radiol,2013,82(4):165-175.
[19]曾献军,段文锋,方磊,等.乳腺结核的临床及MRI特点[J].中华放射学杂志,2011,45(12):1220-1222.
[20]赵秋枫,李琼,王永灵,等.浆细胞性乳腺炎的MRI表现及手术对照研究[J].肿瘤影像学,2013,22(2):107-111.
[21]张超杰,范培芝,刘鹏,等.动态磁共振成像在肉芽肿性乳腺炎手术评估中的应用价值[J].中国现代医学杂志,2012,22(21):86-89.
[22]王永灵,赵秋枫,李琼,等.浆细胞性乳腺炎MRI部位分型与手术方案选择的临床研究[J].中国中西医结合影像学杂志,2015,13(6):598-603.
[23]Frei KA,Kinkel K,Bone1 HM,et al.MR imaging of the breast in patients with positive margins after lumpectomy:influence of the time interval between lumpectomy and MR imaging[J].AJR Am J Roentgenol,2000,175(6):1577-1584.
[24]周纯武,张仁知.MRI随访在乳腺癌诊断和疗效评估中的价值[J].磁共振成像,2011,2(3):166-171.