浆细胞性乳腺炎的MRI表现

MRI Findings of Plasma Cell Mastitis

目的:探讨浆细胞性乳腺炎的MRI表现。方法:51例经临床病理证实的浆细胞性乳腺炎患者纳入研究,全部病例进行MRI检查,包括T1WI、T2WI压脂平扫和动态增强3D T1WI压脂扫描;2位资深放射科医生共同分析其MRI表现并进行分型。结果:浆细胞性乳腺炎的MRI表现可分为炎症型、脓肿型和混合型;炎症型13例(25.5%),病灶局限在乳晕周围(11/13),斑片样或结节样,T1WI呈等低信号(8/13)或等高信号(5/13),压脂T2WI呈高信号(9/13)、高等信号(3/13)或等信号(1/13),增强后不均匀强化(11/13)或结节样均匀强化(2/13);脓肿型34例(66.7%),多数多发(32/34),似卷发样或蜂窝状,境界模糊不清,少数单发(2/34),结节或囊状,T1WI呈等、低信号(30/34)或等高信号(4/34),压脂T2WI呈高等信号(29/34)、高低信号(4/34)或等信号(1/34),增强后脓肿壁呈环状强化;混合型4例(7.8%),脓肿伴细管状低信号的窦道瘘管。结论:浆细胞性乳腺炎的MRI表现具有一定特征性,MRI检查有助于明确诊断。

Purpose： To evaluate the MRI appearances of plasma cell mastitis（PCM） .Methods： Fifty - one patients with PCM confirmed by clinical pathology were enrolled. MRI scans included non - enhanced T1 WI, T2 WI with fat suppression（FS） and enhanced 3D- TIWI with FS. MRI manifestations of PCM were analyzed, and their classification was done by two experienced radiologists. Results： PCM could be divided into three types： the inflammation type （13/51）, the abscess type （34/51） and the mixed type （4/51）. In the inflammation type, patches or nodules connected by strips were showed in 11 （11/13） cases. On non - enhanced T1 WI, iso - and hypointensity was seen in 8（8/13）, iso - and hyperintensity in 5（5/ 13） .On T2WI with fat suppression（FS）, hyperintensity was seen in 9 （9/13）, isointensity in 1（1/ 13）, isoand hyperintensity in 3（3/13） . On enhanced TIWI after contrast, the lesions showed inhomo- geneous enhancement in 11（11/13）, nodule - like homogeneous enhancement in 2（2/13） . In the abscess type, single abscess showed nodules or cyst in 2（2/ 34）; multiple abscesses appeared as hair - like or honeycomb in 32（32/34）. On non- enhanced T1WI, iso- and hypointensity was seen in 30（30/34）, iso- and hyperintensity in 4（4/ 34） .On T2WI with FS, iso- and hyperintensity was seen in 29（29/ 34）, hy- per- and hypointensity in 4（4/ 34）, isointensity in 1（1/ 34） . On TIWI after enhancement, ring- or nodule - like enhancement was found in all lesions. In the mixed type, the hypointensity of sinus and/or fistula was discovered besides abscess in 4（4/ 51） . Conclusion： The MRI manifestations of PCM are of characteristics, which is help for the diagnosis of PCM by MRI.