肉芽肿性乳腺炎的彩色多普勒超声诊断特点及误诊分析

Ultrasonographic characteristics of granulomatous mastitis and analysis of misdiagnosing

目的探讨肉芽肿性乳腺炎二维和彩色多普勒超声表现特点，分析其误诊原因。方法回顾分析经病理证实的12例肉芽肿性乳腺炎患者的二维及彩色多普勒血流特征。结果二维超声表现为乳腺腺体内实质不均质肿块7例，多呈低回声，其内可见腺体样稍强回声，呈“假肾征”，肿块形态不规则；2例肿块内可见无回声区；2例表现为连续或不连续的不规则管状结构样低回声结构，周围可见腺体样稍强回声；1例表现为弥漫性腺体回声紊乱，皮肤增厚，皮下积液，窦道形成。9例合并同侧腋窝淋巴结肿大。CDFI示6例病灶血流分级为Ⅲ级，3例为Ⅱ级，2例为I级，1例病灶内未见血流信号，为0级。血流阻力指数0．58～0．82，平均0．72±0．01。结论彩色多普勒超声对肉芽肿性乳腺炎有重要的诊断和鉴别诊断价值，可临床推广应用。

Objective To explore the ultrasonographic characteristics of granulomatous mastitis and to analyze the mis- diagnosis reason.Methods The ultrasonographie characteristics of 12 patients with granulomatous mastitis confirmed by patholo- gy were retrospectively analyzed. Results Seven cases of granulomatous mastitis presented as heterogeneous lumps in breast and most lumps were hypo-eehonie with irregular shape. Meanwhlie, glandular and slightly hyperecho could be found inside the lump appearing as ＂fake kidney＂ symptom. Aneehonie area was found in 2 cases and the other 2 cases showed as hypoechonic structures with glandular hyperechoes around them. One case presented as diffused eehonie disorders in gland. Nine cases combined with ipsi- lateral axilla lymphadenectasis.The blood flow showed grade llI in 6 cases by CDFI, grade 11 in 3 cases,grade I in 2 cases and grade 0 in 1 case. The resistance index of blood flow ranged from 0.58 to 0.82 with a mean value of 0.72＋0.01.Conclusion Ultra- songraphy has important diagnostic value for granulomatous mastitis and it is worthy of being promoted in clinical application.