肉芽肿性小叶性乳腺炎超声表现

Sonographic findings of granulomatous lobular mastitis

目的探讨肉芽肿性小叶性乳腺炎(GLM)的高频超声图像特征。方法对23例以乳腺包块就诊,经术前超声及手术病理证实为GLM患者的病例资料进行回顾性分析。在灰阶声像图上观察肿块大小、形状、边界、内部回声及后方回声。应用彩色多普勒血流成像(CDFI)观察病灶内部及其周围血流分布和供应情况。结果23例GLM患者(均经手术后病理证实)均为经产妇,年龄20～43岁。灰阶声像图显示12例表现为连续或不连续的不规则管状结构样低回声区,低回声区周围为高回声;5例表现为单发或多发、边界相对清楚、不均质低回声结节或肿块,其内可伴无回声区;5例表现为病变区腺体结构紊乱,未见明确边界,内部回声强弱不一,病变内可见无回声区;1例表现为边界模糊、形态不规则的低回声实质肿块伴后方回声衰减。23例中患处皮肤层增厚8例,6例伴有皮肤破溃,窦道形成。CDFI示22例(22/23)病变内部及周边动静脉血流信号明显增加。结论GLM病变的超声表现具有一定的特点,但这些表现不具有特征性,确诊仍需病理学检查。

Objective The aim of this study was to examine the high-frequency sonographic features of granulomatous lobular mastitis.Methods The sonographic features of 23 patients with granulomatous lobular mastitis confirmed by surgery and histopathology in our hospital from Nov,2003-Dec,2006 were reviewed retrospectively.Results All patients were parous women,ranged in age from 20 to 43 years.On gray-scale sonography:12 cases showed contiguous or discrete irregular tubular hypoechoic lesions with ill-defined margins surrounded by hyperechoic boundaries;5 cases showed solitary or multiple heterogeneous hypoechoic mass or nodules with relatively clear boundaries and inner anechoic areas;5 cases showed gland structural disturbance in lesions withont clear boundaries in which the inner echoes were heterogeneous or sometimes an echoic;one case showed unclear boundary,irregular shape,and hypoechoic mass with posterior attenuation.Fistula formation was seen in 6 cases.CDFI showed increased arterial and venous vascularization within and around the lesions in 22 of 23 patients.Conclusions High-frequency sonographic features of granulomatous mastitis are characteristic but not pathognomonic.A histological confirmation is the only method for definite diagnosis.