少见乳腺炎的影像学诊断

Imaging features of rare mastitis

目的 总结分析少见乳腺炎的B超、钼靶及磁共振的影像学特点,结合病理结果及文献复习探讨这三种影像学检查的诊断价值.方法 回顾性分析第三军医大学第三附属医院2000年1月至2009年6月所有经病理检查确诊并行影像学检查的24例少见乳腺炎,包括一般资料、影像学检查特点、病理结果、诊断符合率.结果 24例中乳腺导管扩张并慢性炎14例,肉芽肿性小叶炎3例,慢性化脓性炎6例,乳腺结核1例;行B超检查13例,诊断符合率为77%,行钼靶检查12例,诊断符合率25%,行MRI检查3例,诊断符合率100%.结论 少见乳腺炎大多在影像学上无特异性表现,但仍有其异于其他乳腺肿块的特点,MRI检查较B超及钼靶检查更准确,联合多种检查手段可以提高诊断符合率.

Objective To summarise the imaging features of rare mastitis and explore the diagnostic value of ultrasound, mammography and MRI for rare mastitis. Methods The record of 24 patients diagnosed as rare mastitis in our hospital from Jan. 2000 to Jun. 2009 was reviewed, including clinical manifestations, pathological results, imaging diagnosis and diagnostic accurate rate. Results Of the 24 patients, 14 patients were ductal ectasia with chronic mastitis, 3 granulomatous mastitis, 6 chronic abscess and 1 mammary tuberculosis. 13 patients underwent ultrasonic scan, 12 patients underwent mammography and 3 patients underwent MRI, with the diagnostic accurate rate 77%, 25% and 100% respectively. Conclusions There are no special imaging manifestations for most rare mastitis, however, some differential characteristics still exist. MRI has a higher accuracy compared to ultrasound and mammography. The combination of multiple imaging methods can improve diagnostic accuracy.