非哺乳期乳腺炎性病变的MRI诊断价值

Diagnostic value of MRI in non-lactation mastitis lesions

目的探讨磁共振成像在非哺乳期乳腺炎性病变中的诊断价值。材料与方法回顾性分析经手术及穿刺病理证实且有完整MRI资料的非哺乳期乳腺炎性病变共83例,分别对病灶形态学、信号强度、表观扩散系数(apparent diffusion coefficient,ADC)值、强化特点及时间信号强度曲线(timeintensitycurve,TIC)类型进行评价及测量。结果 54例表现为肿块,包括单灶(29/54,53.7%)和多灶(25/54,46.3%),形态以不规则形为主(27/54,50.0%),边缘多不规则(27/54,50.0%)或清楚(21/54,38.9%),增强扫描呈不均匀强化(27/54,50.0%)或环形强化(27/54,50.0%)。29例表现为非肿块强化,分布方式以节段样强化为主(16/29,55.2%),增强扫描多呈不均匀强化(20/29,69.0%)。T2WI/IDEAL WATER (T2 weighted image/iteration decomposition of water with echo asymmetry and least-squares estimation)序列多表现为等信号(31/83,37.3%)或稍高信号(31/83,37.3%),扩散加权成像(diffusion weighted imaging,DWI)序列以稍高信号(33/83,39.8%)或高信号(46/83,55.4%)为主,平均ADC值为(1.15±0.30)×10-3 mm2/s。TIC类型以平台型为主(52/83,62.7%)。病灶内常伴有囊变及坏死区(54/83,65.1%)、灶周水肿(35/83,42.2%)、部分病灶伴出血(9/83,10.8%)。伴随征象包括邻近皮肤异常改变(30/83,36.1%)、胸壁异常改变(11/83,13.3%)、同侧腋窝淋巴结肿大(23/83,27.7%)。结论非哺乳期乳腺炎性病变在MR影像上具有一定特征性,与乳腺癌的鉴别诊断价值较大。

Objective:To investigate the value of magnetic resonance imaging(MRI)in the diagnosis of non-lactation mastitis lesions.Materials and Methods:To retrospective analysis of 83 cases of non-lactation mastitis lesions confirmed by surgery and biopsy pathology with complete MRI data,the lesion morphology,signal intensity,apparent diffusion coefficient(ADC)value,enhancement characteristics and time intensity curve(TIC)types were evaluated and measured respectively.Results:Fifty-four cases showed masses,including single focus(29/54,53.7%)and multiple foci(25/54,46.3%).The shape was mainly irregular(27/54,50.0%).The margin was mainly irregular(27/54,50.0%)or clear(21/54,38.9%).The enhancement scan showed heterogeneous(27/54,50.0%)or rim enhancement(27/54,50.0%)respectively.Twentynine cases showed non-mass enhancement(NME).Segmental distribution was the main type(16/29,55.2%).The internal enhancement pattern was mainly heterogeneous(20/29,69.0%).T2 weighted image/iteration decomposition of water with echo asymmetry and least-squares estimation(T2WI/IDEAL WATER)sequence showed middle(31/83,37.3%)or slightly high signal intensity(31/83,37.3%).Diffusion weighted imaging(DWI)sequence was mainly slightly high(33/83,39.8%)and high signal intensity(46/83,55.4%).The average value of ADC was(1.15±0.30)×10^-3 mm^2/s.TIC was mainly plateau type(52/83,62.7%).The lesions were complicated by cystic degeneration and necrosis(54/83,65.1%),peripheral edema(35/83,42.2%)and hemorrhage(9/83,10.8%).Accompanying signs included adjacent abnormal skin changes(30/83,36.1%),abnormal chest wall change(11/83,13.3%)and axillary lymph node enlargement at the same side(23/83,27.7%).Conclusions:Non-lactation mastitis lesions have some characteristics on magnetic resonance imaging,which is of great value in differential diagnosis with breast cancer.