非哺乳期乳腺炎性病变的MRI表现及其与病理的对照研究

MRI findings of inflammatory breast diseases with pathologic correlation in non-lactating woman

目的 探讨非哺乳期乳腺炎性病变的MRI表现及其病理基础。方法 回顾性分析术前行动态增强乳腺MRI检查,且经病理确诊的非哺乳期乳腺炎性病变患者78例。其中27例行DWI检查。观察MR图像上病灶的动态增强特点及DWI表现。病灶内部强化分为环形强化、不均匀强化（Ⅰ型和Ⅱ型）、均匀强化及集簇状强化。观察4种主要病理改变（脓肿、导管扩张、炎性囊肿和其他炎性表现）的出现情况。将MRI和病理结果进行对照。结果 78例中,环形强化55例,不均匀强化Ⅰ型10例,不均匀强化Ⅱ型9例,均匀强化2例,集簇状强化2例。27例行DWI的患者中,17例病灶内部强化为环形强化,在DWI上均呈中央高信号,其病理表现多为炎性囊肿（9例）和脓肿（8例）;1例呈环形强化,在DWI上呈周边高信号,其病理表现为炎性囊肿;3例呈不均匀强化Ⅰ型,在DWI上均呈不均匀高信号,其病理表现均为其他炎性表现;6例呈不均匀强化Ⅱ型,在DWI上均呈类圆形或条状高信号,其病理表现为脓肿（5例）及导管扩张（3例）。结论 非哺乳期乳腺炎性病变在MRI上具有一定特征,其MRI表现和病理基础有关。

Objective To evaluate the MRI findings of inflammatory breast diseases with pathologic correlation in non-lactating woman.Methods Seventy-eight patients with non-lactating inflammatory breast diseases confirmed by surgicopathology were respectively reviewed.All these patients had a preoperative dynamic contrast-enhanced MRI examination,and 27 had undergone the DWI.MRI findings were reviewed for dynamic enhancement characteristics and the DWI findings.The internal enhancement patterns were classified as rim enhancement,heterogeneous（Ⅰ and Ⅱ）,homogenous enhancement,and clumped enhancement.The four main pathological findings were reviewed as follows：abscess,dilated duct,inflammatory cyst,and other inflammatory changes.The MRI findings of the lesion and the corresponding pathological features were analyzed.Results Among the 78 patients,internal enhancement patterns were rim enhancement（n=55）,heterogeneous enhancement Ⅰ （n=10）,heterogeneous enhancement Ⅱ（n=9）,homogenous enhancement（n=2）,and clumped enhancement（n=2）.Of the 27 patients who underwent DWI,17 patients showed rim enhancement and a central hyperintensity on DWI,the pathological findings were more frequently inflammatory cyst（n=9） and abscess（n=8）.One patient showed rim enhancement and a peripheral hyperintensity on DWI,the pathological finding was an inflammatory cyst.Of the 3 patients showing heterogeneous enhancement Ⅰ and heterogenous hyperintensity on DWI,the pathological findings were other inflammatory changes.Of the 6 patients showing heterogeneous enhancement Ⅱ and oval or linear hyperintensity on DWI,the pathological findings were abscess（n=5） and dilated duct（n=3）.Conclusions Inflammatory breast diseases in non-lactating women show relative characteristic features on MRI.MRI findings of these kinds of diseases are associated with its pathological background.