乳腺结节性筋膜炎的影像学表现及临床分析

Imaging manifestations and clinical analysis of nodular fasciitis of the breast

目的探讨乳腺结节性筋膜炎(breast nodular fascitis,BNF)的超声检查、X线摄影、MRI检查的影像表现。方法选取我院经手术病理证实的BNF患者17例,分析影像学表现及临床病理特点。结果17例患者术前均行超声检查有记录的17个病灶中,1个位于皮肤层,8个位于皮下脂肪层,8个位于腺体层;形态不规则15例,椭圆形2例;边缘成角或毛刺状16例,光整1例;5个非腺体层的病灶周围见高回声晕。6个有乳腺X线摄影检查记录的病灶均未见钙化;13个有MR增强检查记录的病灶中,11个时间-信号曲线为非流出型。镜下肿块见大量梭形细胞增生、边界多不清。结论对于中青年乳腺皮下脂肪层快速生长、常规超声检查周围见高回声晕、乳腺X线摄影未见钙化、MRI增强曲线呈非流出型的病灶应考虑BNF的可能。

Objective To investigate the ultrasound,mammography,MRI image manifestations and clinicopathological features of breast nodular fascitis(BNF).Methods 17 cases of BNF patients confirmed by surgery and pathology in our hospital were selected,their preoperative clinical and imaging datas were retrospectively analyzed,and their imaging manifestations,clinical and pathological characteristics were summarized.Results All patients were female,with an average age of 38 years(19~61 years).Among the 17 lesions recorded by ultrasonography,1 was located in the skin layer,8 were located in the subcutaneous fat layer,and 8 were located in the glandular layer;15 cases were irregular in shape,and 2 cases were oval;the margins were lobulated or spiculated in 16 cases,and smooth in 1 case;hyperechoic halos were seen around 5 non-glandular lesions.No calcification was found in 6 lesions recorded by mammography;among 13 lesions recorded by MR enhanced examination,11 time-signal curves were non-outflow type.The mass under the microscope showed a large number of spindle cells hyperplasia with unclear borders;immunohistochemistry showed that smooth muscle actin(SMA).Conclusion In young and middle-aged patients,the possibility of BNF should be considered for the subcutaneous fat layer masses that grow rapidly,with high echo halo around in conventional ultrasound,without calcification in mammography,and appear non-outflow enhancement curve on MR.