超声成像联合磁共振功能成像在乳腺肉芽肿性小叶性乳腺炎诊断中的价值

Diagnostic value of ultrasound imaging combined with magnetic resonance imaging in granulomatous lobular mastitis of the breast

目的探讨超声成像联合磁共振功能成像在肉芽肿性小叶性乳腺炎诊断中的价值。方法分析肉芽肿性小叶性乳腺炎超声的病变类型,回声特点,后方声影变化,血供及乳腺超声BI-RADS分级;分析磁共振乳腺病变的位置、大小、形态、边界、信号特点、时间信号曲线类型,有无腋窝淋巴结肿大,乳腺MRI-BI-RADS分级。结果 62例超声检查以结节肿块型为主,占比66.13%;以低回声为主,比例为61.29%;病变血供变化以少血供或无血供为主,共占比为87.10%。超声-BI-RADS分级以4类为主,占比为56.45%。32例MRI检查中,以脓肿型主,占43.75%。DWI序列以弥散受限为主,占比65.63%,在脓肿型为100%。时间信号强化曲线类型以平台型为主,比例约84.38%。18例病变邻近皮肤增厚,占比约56.25%。12例合并同侧腋窝淋巴结肿大,占比约37.50%。MRI-BI-RADS分级以3级或4级为主,共占比约84.38%。超声检查诊断符合率约37.10%,MRI检查诊断符合率约71.88%,两种检查方法联合诊断符合率约80.77%。结论肉芽肿性小叶性乳腺炎的超声成像、磁共振功能成像具有一定的影像特征,多发微脓肿的形成为本病特征性表现,两者联合应用可进一步提高本病的诊断能力。

Objective To evaluate the diagnostic value of ultrasound imaging combined with magnetic resonance imaging in granulomatous lobular mastitis（GLM）. Methods To analyze the types of ultrasonic lesions,echo characteristics,changes in posterior sound and shadow,blood supply and BI-RADS classification of breast ultrasound of GLM. To analyze the location,size,shape,boundary,signal characteristics,time signal type,axillary lymph node enlargement and MRI-BI-RADS classification of the breast of GLM. Results In 62 cases of ultrasonography,mainly nodular or lump type was 66.13%,the proportion of hypoechoic was 61.29%,and less blood supply or no blood supply was 87.10%. The-BI-RADS classification of ultrasound was mainly in 4 categories,accounting for 56.45%. The diagnostic coincidence rate of ultrasonography is about 37.10%. The diagnostic coincidence rate of MRI is about 71.88%. The diagnostic coincidence rate of the two methods is 80.77%. Conclusion The ultrasonic and MRI of granulomatous lobular mastitis have certain imaging features,and the formation of multiple microabscesses is the characteristic manifestation of this disease. The combination of them can further improve the diagnostic ability of the disease.