磁共振动态增强联合弥散加权成像对特发性肉芽肿性乳腺炎的临床诊断分析

Clinical Diagnosis of Idiopathic Granulomatous Mastitis by Dynamic Magnetic Resonance Enhancement Combined with Diffusion-weighted Imaging

目的分析磁共振成像动态增强扫描(DCE)联合弥散加权成像(DWI)对特发性肉芽肿性乳腺炎(IGM)的临床诊断应用价值。方法方便收集2015年1月—2016年12月在该院经过手术及病理证实的特发性肉芽肿性乳腺炎患者27例,所有患者均行磁共振成像动态增强扫描和弥散加权成像,回顾性总结分析IGM的磁共振影像表现特点。结果 27例IGM患者中,病灶分布在乳晕后区9例,周围区段18例;病灶形态呈肿块样10例,非肿块样16例;病灶边缘光滑4例,模糊22例,毛刺样1例;均匀强化3例,不均匀强化24例;病灶内小脓腔19例;TIC为流入型9例,平台型13例,流入型5例;乳头内陷13例,皮肤增厚水肿11例,淋巴结肿大25例,术前误诊为乳腺癌11例。实质部分平均ADC值(1.58±0.15)×10^(-3)mm^2/s。结论 IGM在磁共振表现形式上存在一定的特征性,DCE联合DWI有助于IGM的临床诊断。

Objective To analyze the value of dynamic contrast-enhanced magnetic resonance imaging(DCE)combined with diffusion-weighted imaging(DWI)in the diagnosis of idiopathic granulomatous mastitis(IGM).Methods 27 patients with idiopathic granulomatous mastitis confirmed by surgery and pathology from January 2015 to December 2016 were conveniently enrolled.All patients underwent magnetic resonance imaging with dynamic contrast-enhanced scanning and diffusion-weighted imaging.Analyze the magnetic resonance imaging characteristics of IGM.Results In 27 cases of IGM,the lesions were distributed in 9 cases of posterior areola and 18 cases in surrounding area.There were 10 cases of mass lesions and 16 cases of non-mass lesions.The lesions were smooth in 4 cases,blurred in 22 cases,and burr-like cases in 1 case.There were 3 cases of uniform enhancement,24 cases of uneven enhancement;19 cases of small abscess in lesions;9 cases of inflow type,13 cases of platform type,5 cases of inflow type;13 cases of nipple retraction,11 cases of skin thickening and edema,25 cases of lymphadenopathy,and 11 cases were misdiagnosed as breast cancer before operation.The average partial ADC value(1.58±0.15)×10-3 mm2/s.Conclusion IGM has certain characteristics in the form of magnetic resonance.DCE combined with DWI is helpful for the clinical diagnosis of IGM.