摘要
目的提高对小叶肉芽肿性乳腺炎的MRI表现的认识,并与非肿块性乳腺癌进行鉴别。方法对11例小叶肉芽肿性乳腺炎的MRI征象进行回顾性分析,并与13例非肿块性乳腺癌进行比较,所有病例均经手术及病理证实。MRI采用T2WI-FS、DWI和动态增强扫描。分析征象包括病变的表观扩散系数(ADC)值、动态扫描时间-信号强度曲线的类型和病变形态学特征。两种病变的MRI表现的差异性作统计学分析。结果小叶性乳腺炎ADC值为(1.036±0.373)mm2/s,非肿块性乳腺癌ADC值为(1.069±0.406)mm2/s(t=-0.298,P=0.768,P>0.05),两组数据差异无显著统计学意义。形态上分析,小叶肉芽肿性乳腺炎病变边缘以"网格"状改变为主,增厚的腺体内无结节,见规则的脓腔;非肿块性乳腺癌边缘以毛刺为主,内含结节状改变,少有囊变坏死腔,两者征象差异具有显著统计学意义(χ2=1.68,P=0.00,P<0.05)。动态增强的时间-信号强度曲线类型:小叶肉芽肿性乳腺炎和非肿块性乳腺癌均可表现为流出型和平台型,两者曲线类型具有重叠(χ2=1.68,P=0.194,P>0.05)。结论虽然小叶肉芽肿性乳腺炎和非肿块性乳腺癌在MRI功能成像的表现无差异,但形态学表现明显不同,说明小叶肉芽肿性乳腺炎表现具有特征性。认识其特殊的MRI形态学表现,对诊断小叶肉芽肿性乳腺炎及与乳腺癌的鉴别有重要意义。
Objective To improve MRI diagnosis of granulomatous lobular mastitis and differentiate diagnosis from non- mass breast cancer. Methods MRI manifestation of 11 patients with granulomatous lobular mastitis and 13 patients with non mass breast cancer were retrospectively analyzed and compared. All the eases were approved by histopathology. The MRI sequences included T2WI fs, DWI and dynamic enhanced scan. The MRI manifestations included ADC values, type of time-signal curve and morphologic characters of T2WI and enhanced imagings were analyzed. Results The ADC value was （ 1. 036 ± 0.373 ） mm2/s in lobule mastitis, and （ 1. 069 ± 0. 406） mm2/s in non-mass breast cancer, there was no sig- nificant difference between lobule mastitis and breast cancer （t = -0. 298 ,P = 0. 768 ,P 〉 0.05 ）. According to morpholo- gy, granulomatous lobular mastitis showed gridding margins, focus abscesses and no nodules. Non-mass breast cancer showed spicular margins, nodules enhancement, no abscesses. The morphology manifestation had significant difference be- tween granulomatous lobular mastitis and non mass breast cancer（ X2 = 1.68 ,P = 0. 00 ,P 〈 0.05 ）. The time signal curves of dynamic enhanced scans showed ＂ inflow＂ type and＂ flat＂ type in granulomatous lobular mastitis and non-mass breast cancer . The time signal curves had overlapped between granulomatous lobular mastitis and non mass breast cancer（ X2 = 1.68,P = 0. 194,P 〉 0.05 ）. Conclusion Granulomatous lobular mastiffs has characters in MRI manifestation, Morphol- ogy and structure displayed on MRI are helpful in differential diagnosing granulomatous lobular mastitis with non mass
出处
《临床放射学杂志》
CSCD
北大核心
2013年第8期1101-1105,共5页
Journal of Clinical Radiology
关键词
小叶肉芽肿性乳腺炎
非肿块性乳腺癌
磁共振成像
诊断与鉴别诊断
Granulomatous lobular mastitis Non-mass breast cancer Magnetic resonance imaging Diagnosis anddifferentiating diagnosis
