特发性乳腺炎的声像学表现与误诊分析

Ultrasonic feature and misdiagnosis of idiopathic mastitis

目的分析特发性乳腺炎的声像学表现,以提高术前超声诊断符合率。方法选择经病理组织检查证实特发性乳腺炎患者77例,均为女性,年龄16~60岁,平均年龄39.6岁。术前行超声检查。取手术切除病灶或粗针穿刺取材,做病理组织检查。回顾性分析超声与病理组织诊断结果。结果特发性乳腺炎多表现为形态不规则的、不均质低回声病灶,纵横比小于0.7,边缘不清晰,部分病灶内可见囊性成分,后方回声增强,但微钙化、高回声晕及腋窝淋巴结肿大少见,病灶血液供应多不丰富。术前37.66%（29/77）病例误诊为乳腺癌。结论特发性乳腺炎具有一定的声像学特征,检查者应结合临床资料综合分析,提高诊断符合率。

Objective To analyze the ultrasound feature of idiopathic mastitis, and improve the diagnostic coincidence rate. Methods A total of 77 female patients with idiopathic mastitis pathologically confirmed by pathological section were enrolled, which aged 16 - 60 years old with mean age of 39.6 years old. The preoperative ultrasound was performed, then surgical excision of lesion or coarse needle biopsy and pathological tissues were determined. The diagnosis results of ultrasound images and pathological were retrospectively analyzed. Results Most of idiopathic mastitis showed low echo lesions with irregular shape, unclear border and inhomogeneous internal echo. The A/F ratio was calculated less than 0.7. Some lesions showed cystic with posterior acoustic enhancement, while microcalcifications, hypereehoic halo and axillary lymphadenopathy were rare, the blood supply was shortage, and 37.66 % （29/77） lesions were misdiagnosed as breast cancer. Conclusion It is demonstrated that idiopathic mastitis owns some ultrasonic features, which could improve the diagnostic coincidence rate in combination with comprehensive analysis of clinical data.