对比分析彩色多普勒超声诊断肉芽肿性乳腺炎与乳腺浸润性导管癌

Comparative analysis on ultrasonic diagnosis for granulomatous mastitis and invasive ductal carcinoma

目的对比分析肉芽肿性乳腺炎(GLM)与乳腺浸润性导管癌(IDC)的超声特点。方法回顾性分析经病理检查证实的26例GLM与28例IDC的超声检查结果,分析其声像图特征。结果 GLM病灶形态多不规则、边界不清晰、血流信号中等或较丰富,与IDC较相似。GLM病灶L/T值明显高于IDC,53.85%(14/26)的GLM病灶后方回声增强,而35.71%(10/28)IDC病灶后方回声衰减,且IDC患者PSV、阻力指数值及腋窝淋巴结肿大发生率均明显高于GLM。本组26例GLM中,术前超声仅诊断4例为炎症,28例IDC术前超声检查均诊断为恶性肿瘤。结论 GLM与IDC的声像学表现既有相似之处,同时亦各具特征,详细检查、综合分析有助于提高术前诊断的准确率。

Objective To compare the ultrasonic characteristics of granulomatous mastitis （GLM） and invasive ductal carcinoma （IDC）. Methods Ultrasonic features of 26 patients with GLM and 28 patients with IDC confirmed by pathology were analyzed retrospectively. Results Most GLM displayed irregular shape, unclear boundary with medium or abundant blood flow, which were similar to IDC. The L/T ratio of GLM was much higher than that of IDC, and 53.85% （14/26） of GLM showed enhanced posterior echo, while 35.71% （10/28） of IDC showed attenuated posterior echo. The incidence of lymphadenectasis, as well as peak systolic velocity and resistance index in IDC were much higher than those in GLM. Only 4 patients with GLM were diagnosed as inflammation by preoperative ultrasonography, while 28 IDC were all diagnosed as malignant tumor by ultrasound before operation. Conclusion There are not only similar ultrasonic features but also different characteristics between GLM and IDC. Detailed ultrasonic examination and comprehensively analyzing would be helpful to improving diagnostic coincidence rate of GLM before operation.