非哺乳期乳腺炎MRI表现及与非肿块性乳腺癌的鉴别诊断

MRI Manifestation of Non-Lactation Mastitis and Differentiating from Non-Mass Breast Cancer

目的认识非哺乳期乳腺炎的MRI表现,并与非肿块性乳腺癌鉴别。方法对17例非哺乳期乳腺炎的MRI征象进行回顾性分析,并与16例非肿块性乳腺癌进行比较,所有病例均经手术或穿刺活检病理证实。分析术前MRI征象包括病变形态学特征,动态增强扫描时间-信号强度曲线(TIC)类型和病变表观扩散系数(ADC值),将两种病变的MRI表现差异作统计学分析。结果形态分布上非哺乳期乳腺炎以不按导管系统的区域或多区域分布为主,非肿块性乳腺癌以按导管系统的节段性分布为主。内部强化特征上非哺乳期乳腺炎强化的腺体内少结节,多见规则脓腔或囊腔;非肿块性乳腺癌内见结节状强化或不均匀网格状或小簇环状改变,少有囊变坏无效腔,动态增强TIC类型两者比较,差异无统计学意义(P>0.05)。非哺乳期乳腺炎非脓肿及囊变区与非肿块性乳腺癌ADC值比较,差异有统计学意义(P<0.05)。结论两者形态学表现不同,非哺乳期乳腺炎MRI表现具有一定的特征性,有助于与乳腺癌鉴别。

Objective To clarify the MRI manifestations of non-lactation mastitis,and to distinguish non-mass breast cancer and non-lactation mastitis.Methods By reviewing and analyzing17cases of the MRI manifestations of non-lactation mastitis,and comparing with16cases of non-mass breast cancer.All the cases have been confirmed either by operation or by aspiration biopsy.MRI manifestations before operation,including pathological morphology,types of time-intensity curve,and apparent diffusion coefficient,are analyzed and compared.Statistical analysis is applied to the MRI manifestation differences between two different diseases.Results sNon-lactation mastitis does not distribute in catheter system area or multi-areas,while non-mass breast cancer distributes segmentally in catheter system.There is statistical significance in the differences of two diseases(P<0.05).The enhanced glands of non-lactation mastitis have fewer nodules,more vomica and cysts,while the glands are nodular enhanced,or varied reticularly and clustered.Fewer necrotic cavities are seen.There is statistical significance in the differences of two diseases(P<0.05).As for dynamic enhancement of TIC types,there is no statistical significance(P>0.05).The ADC value of non-abscess and cystic variation area of non-lactation mastitis is(1.336±0.275)×10-3mm2/s.The ADC value of non-mass breast cancer is(1.079±0.244)×10-3mm2/s.There is statistical significance(t=2.470,P=0.021,P<0.05).Conclusion Themorphologic features of these two diseases are different.Non-lactation mastitis has a characteristic manifestation,which helps to distinguish breast cancer.