非哺乳期乳腺炎X线摄影及磁共振表现对照研究

Correlative Analysis of Full-field Digital Mammography and MRI Findings of Breast non-lactation Mastitis

目的探讨非哺乳期乳腺炎全数字化乳腺X线摄影(full-fielddigitalmammography,FFDM)及MRI的影像学表现,评价其对非哺乳期乳腺炎性疾病的诊断价值。方法收集26例非哺乳期乳腺炎性疾病患者,均经穿刺或手术病理证实,回顾性分析其乳腺X线摄影及MRI影像学表现,并进行对照分析。同时收集3例炎性乳癌病例,分析其X线摄影及MRI表现。结果 26例患者中,慢性乳腺炎17例,肉芽肿性乳腺炎7例,浆细胞性乳腺炎2例。乳腺X线摄影表现为局部腺体致密16例,肿块8例,结构扭曲1例,无直接征象,仅表现为局部皮肤增厚1例;MRI平扫病灶T1WI呈低、等信号,T2WI呈等、高或混杂信号,增强扫描呈非肿块样强化18例,肿块样强化8例。3例炎性乳癌X线及MRI表现与急性乳腺炎相似,其中1例X线摄影出现恶性钙化,可以确诊。结论非哺乳期乳腺炎与乳腺癌临床及影像学检查有时较难鉴别,乳腺X线摄影与MRI联合应用能提供更多影像学信息,提高该病诊断准确率。

Objective To study the imaging and evaluate the diagnosis value of breast nonlactation mastitis with full-field digital mammography（FFDM）and MRI.Methods Collected 26 cases of mastitis and another 3 cases of inflammatory breast cancer which were certified by pathology,and retrospective analyzed the X-ray and MRI features.Results Of the 26 cases,17 were chronicity mastitis,7 were granulomatous mastitis,and 2 were plasma cell mastitis.The findings were shown in FFDM：16 were localized asymmetric density,8 were mass,2 were focal architectural distortion,and 1 was thickening of skin,without direct sign.The MR sings of mastitis lesions included low or isointensity signal on T1WI images,isointensity？？hyperintensity or promiscuity signal on T2WI images.The mastitis lesions appeared patchy enhancement were 18 cases,and mass sample enhancement were 8 cases.The 3 cases of inflammatory breast cancer were similar with acute mastitis,and 1 case appeared malignant calcification which could final diagnosis.Conclusion It is difficult to distinguish non-lactation mastitis and breast cancer in clinical and iconography at times.X-ray mammography in combination with MRI could supply more iconography information,and improve the diagnosis accurate rate of these diseases.