肉芽肿性乳腺炎的MRI表现及误诊分析

MRI FINDINGS OF GRANULOMATOUS MASTITIS AND THE ANALYSIS OF MISDIAGNOSIS

目的总结肉芽肿性乳腺炎的MRI特点并分析误诊原因,提高其诊断率。方法回顾性分析经手术病理证实的26例肉芽肿性乳腺炎患者的临床及MRI资料,总结其MRI特点。结果1 MRI表现:MRI平扫无特异性。增强扫描病变按分布形态分为肿块样强化6例和非肿块样强化20例;按强化方式分为均匀强化2例,不均匀强化8例,不均匀强化伴环形强化16例。10例患者DWI呈略高信号,16例患者呈略高信号伴内部圆形极高信号。病变实质区TIC曲线渐增型6例、平台型13例和流出型7例。2MRI诊断:本组26例肉芽肿性乳腺炎患者23例诊断为炎性病变,3例诊断为乳腺癌。3治疗结果:26例肉芽肿性乳腺炎患者均行手术治疗,21例治愈,5例未治愈患者通过二次手术治愈。讨论虽然肉芽肿性乳腺炎的临床表现及影像特点与乳腺癌相似,但也有一定的特征性。提高对该病不同时期的认识、结合各种影像学资料并综合分析病情可有效避免或减少肉芽肿性乳腺炎的误诊。

Objective To summarize the MRI features of granulomatous mastitis and analyze the misdiagnosis reasons and improve its diagnostic rate.Methods A retrospective analysis of the 26 cases confirmed by surgery pathology granulomatous mastitis was performed,and then the patient＇s clinical and MRI data were summarized.Results MRI scan was no specificity.According to the distribution pattern,enhanced scan lesions was divided into mass samples to strengthen 6 cases,and strengthen the mass samples 20 cases.According to the improved ways,they were divided into uniform reinforcement in 2 cases,non-uniform strengthens in 8 cases,uneven improved with annular improved in 16 cases.DWI was slightly high signal in 10 patients,16 patients were slightly higher signals with high internal circle.Lesions essence area TIC curve type was in6 cases,platform type in13 cases increasing type and out of in7 cases.MRI in the diagnosis of 23 patients with this group of 26 cases of granulomatous mastitis diagnosed with inflammatory lesions,3 patients diagnosed with breast cancer.6 cases of granulomatous mastitis treatment outcome in patients with surgical treatment,21 cases were cured,5 cases were not cured patients treated by secondary surgery.Conclusions Although the clinical manifestations and imaging features of granulomatous mastitis and breast cancer are similar,but also to have certain characteristic.To improve the understanding of the disease in different periods,we should combine various imaging data and comprehensive analysis for effectively avoid or reduce the misdiagnosis of granulomatous mastitis.