乳腺炎性病变的超声造影表现及误诊分析
|
摘要
目的探讨乳腺炎性病变的超声造影表现并分析其误诊原因。方法回顾分析经病理证实的60个乳腺炎性病灶,定性分析其超声造影增强表现及预测模型,并对其误诊原因进行分析。结果 60个乳腺炎性病灶超声造影增强主要表现为快进、非向心性、不均匀性高增强,蟹足征和滋养血管少见。超声造影后符合良性预测模型者23个,符合恶性预测模型者37个,即超声造影后将乳腺炎性病变判为恶性的概率为61.7%。其中化脓性乳腺炎和肉芽肿性乳腺炎多符合恶性预测模型。结论乳腺炎性病变超声造影后仍易误诊为乳腺癌,需结合临床症状及多种影像学诊断技术综合判断,最终确诊仍依靠病理诊断结果。
Objective To investigate the contrast-enhanced ultrasound features of mastitis lesions and analyze the causes of misdiagnosis. Methods Data of 60 lesions of clinicly confirmed mastitis were examined by contrast-enhanced ultrasound were retrospectively analyed. The contrast-enhanced ultrasound findings were qualitatively analyzed and its corresponding contrast prediction model was established,and the causes of misdiagnosis was analyzed.Results The contrastenhanced ultrasound features of 60 lesions mainly showed non-centripetally fast wash-in,heterogeneous high enhancement,while crab legs sign and trophoblastic vessels were rare.The contrast-enhanced ultrasound findings of 23 lesions conform to the benign prediction model and 37 lesions conform to the malignant prediction model.The probability of judging mastitis lesions as malignant lesions after contrast-enhanced ultrasound was 61.7%.In them,suppurative mastitis and granulomatous mastitis mostly conform to malignant prediction models.Conclusion Mastitis lesions are easy to be misdiagnosed as breast cancer by contrastenhanced ultrasound,which needs to be comprehensively judged according to clinical symptoms and various imaging diagnostic techniques.The final diagnosis depends on pathological diagnosis results.
Objective To investigate the contrast-enhanced ultrasound features of mastitis lesions and analyze the causes of misdiagnosis. Methods Data of 60 lesions of clinicly confirmed mastitis were examined by contrast-enhanced ultrasound were retrospectively analyed. The contrast-enhanced ultrasound findings were qualitatively analyzed and its corresponding contrast prediction model was established,and the causes of misdiagnosis was analyzed.Results The contrastenhanced ultrasound features of 60 lesions mainly showed non-centripetally fast wash-in,heterogeneous high enhancement,while crab legs sign and trophoblastic vessels were rare.The contrast-enhanced ultrasound findings of 23 lesions conform to the benign prediction model and 37 lesions conform to the malignant prediction model.The probability of judging mastitis lesions as malignant lesions after contrast-enhanced ultrasound was 61.7%.In them,suppurative mastitis and granulomatous mastitis mostly conform to malignant prediction models.Conclusion Mastitis lesions are easy to be misdiagnosed as breast cancer by contrastenhanced ultrasound,which needs to be comprehensively judged according to clinical symptoms and various imaging diagnostic techniques.The final diagnosis depends on pathological diagnosis results.
引文
[1]王欣.应重视非哺乳期乳腺炎的诊治和研究[J].中华乳腺病杂志(电子版),2013,7(3):154-156.
[2]罗俊,陈吉东,陈琴,等.乳腺良恶性病灶超声造影预测模型在乳腺影像报告与数据系统4类乳腺病灶恶性风险评估中的应用价值[J].中华医学超声杂志(电子版),2016,14(6):459-465.
[3]安绍宇,刘健,谢婷,等.乳腺炎性病变超声造影图像分析[J].临床超声医学杂志,2012,14(2):134-135.
[4] Tuli R,O’Hara BJ,Hines J,et al.Idiopathic granulomatous mastitis masquerading as carcinoma of the breast:a case report and review of the literature[J].Int Semin Surg Oncol,2007,27(7):21.
[5] Zhao H,Xu R,Ouyang Q,et al. Contrast-enhanced ultrasound is helpful in the differentiation of malignant and benign breast lesions[J].Eur J Radiol,2010,73(2):288-293.
[6]赵川,李俊萱,刘雪梅.肿瘤血管生成机制的研究进展[J].中华中医药学刊,2017,35(1):130-132.
[7] Bzyl J,Palmowski M,Rix A,et al. The high angiogenic activity in very early breast cancer enables reliable imaging with VEGFR2-targeted microbubbles(BR55)[J].Eur Radiol,2013,23(2):468-475.
[8]张静雯,周建桥,詹维伟,等.乳腺癌超声表现与其病理基础的相关性研究[J].中华医学超声杂志(电子版),2011,8(6):1209-1218.
[9]王芬,陈敏,黄雅芳,等.超声对非哺乳期乳腺炎性病变的诊断价值[J].中华超声影像学杂志,2010,19(10):917-918.
[10]程涓,杜玉堂,丁华野.肉芽肿性小叶性乳腺炎临床病理观察[J].中华病理学杂志,2010,39(10):678-680.
[2]罗俊,陈吉东,陈琴,等.乳腺良恶性病灶超声造影预测模型在乳腺影像报告与数据系统4类乳腺病灶恶性风险评估中的应用价值[J].中华医学超声杂志(电子版),2016,14(6):459-465.
[3]安绍宇,刘健,谢婷,等.乳腺炎性病变超声造影图像分析[J].临床超声医学杂志,2012,14(2):134-135.
[4] Tuli R,O’Hara BJ,Hines J,et al.Idiopathic granulomatous mastitis masquerading as carcinoma of the breast:a case report and review of the literature[J].Int Semin Surg Oncol,2007,27(7):21.
[5] Zhao H,Xu R,Ouyang Q,et al. Contrast-enhanced ultrasound is helpful in the differentiation of malignant and benign breast lesions[J].Eur J Radiol,2010,73(2):288-293.
[6]赵川,李俊萱,刘雪梅.肿瘤血管生成机制的研究进展[J].中华中医药学刊,2017,35(1):130-132.
[7] Bzyl J,Palmowski M,Rix A,et al. The high angiogenic activity in very early breast cancer enables reliable imaging with VEGFR2-targeted microbubbles(BR55)[J].Eur Radiol,2013,23(2):468-475.
[8]张静雯,周建桥,詹维伟,等.乳腺癌超声表现与其病理基础的相关性研究[J].中华医学超声杂志(电子版),2011,8(6):1209-1218.
[9]王芬,陈敏,黄雅芳,等.超声对非哺乳期乳腺炎性病变的诊断价值[J].中华超声影像学杂志,2010,19(10):917-918.
[10]程涓,杜玉堂,丁华野.肉芽肿性小叶性乳腺炎临床病理观察[J].中华病理学杂志,2010,39(10):678-680.