非哺乳期乳腺炎与乳腺癌的MRI鉴别诊断

The Value of MRI in Differential Diagnosis of Non-Lactating Inflammatory Breast Lesions and Breast Cancer

目的探讨非哺乳期乳腺炎的MRI,DWI的表现和乳腺癌的鉴别诊断价值。方法搜集经病理证实的乳腺炎22例和乳腺癌50例,回顾性分析其MRI及DWI表现,用χ2检验比较两组患者病变形态学特征、淋巴结肿大、患侧供血动脉的增粗、强化特征以及TIC类型,用t检验比较两组病灶的强化程度和ADC值。结果22例乳腺炎中,20例边缘模糊,17例伴淋巴结肿大,18例病变强化呈非肿块样,15例病灶的供血动脉增粗,强化程度为427±74;50例乳腺癌中,39例边缘模糊,34例伴有肿大淋巴结,37例呈非肿块样强化。27例病灶的供血动脉增粗,强化程度为431±60,以上差异无显著性。乳腺炎TIC曲线类型Ⅰ,Ⅱ,Ⅲ型分别为7例,9例,6例,ADC值为(1.35±0.47)×10-3mm2/s,乳腺炎TIC曲线类型Ⅰ,Ⅱ,Ⅲ型分别为3例,25例,22例,ADC值为(1.08±0.32)×10-3mm2/s,乳腺炎与乳腺癌的TIC曲线类型及ADC值有统计学意义。结论乳腺炎有乳腺癌MR征象有一定的重叠区,DCE-MRI和DWI对乳腺炎和乳腺癌的鉴别诊断具有重要意义。

Objective To investigate magnetic resonance imaging（ MRI） and DWI findings of non-lactating inflammatory breast lesions. Methods Twenty-two patients with non-lactating inflammatory breast lesions and 50 patients with breast cancer were retrospectively analyzed the MRI and DWLx2 test was used to compare two groups of patients with lesions morphology, swollen lymph nodes,the enlargement of blood supply arteries, strengthening characteristics and TIC types, the enlargement of blood supply arteries, strengthening characteristics and TIC types, t-test was used to compare two groups of lesions of intensive degree and the ADC values. Results Twenty-two non-lactating in- flammatory breast lesions, the edges in 20 cases were. fuzzy, 17 cases with lymph node enlargement, strengthening of 18 cases of the lesions is not bump, blood supply arteries enlargement of 15 cases of lesions, strengthen the degree of 427±74 ;50 cases breast cancer, 39 cases edge showed blur,34 patients with enlarged lymph nodes ,37 cases non tumor sample reinforcement. Blood supply artery enlargement of 27 cases of lesions, strengthen the level of 431 ± 60. The above differences were statistically insignificant. Non-lactating inflammatory breast lesions the TIC curve type I , Ⅱ ,Ⅲ were 7 cases,9 cases,6 cases respectively,ADC values for（ 1.35 ± 0.47） ×10-3 mm2/s, breast cancer TIC curve type I , Ⅱ, Ⅲ were 3 cases,25 cases,22 cases respectively,ADC values for（ 1.08 ±0.32） × 10 -3 mm2/s. TIC curve and ADC type of masti- tis and breast cancer was statistically significant. Conclusion The MR signs of non-lactating inflammatory breast lesions and breast cancer have a certain overlap region, DCE MRI and DWI for non-lactating inflammatory breast lesions and the differential diagnosis of breast cancer are of great significance.