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目的探讨慢性肉芽肿性乳腺炎(GM)的磁共振成像(MRI)表现特征,提高对该病的诊断正确率。方法对本院2012年1月~2015年10月收集的8例经病理证实的GM患者的临床资料和病变形态、信号、动态增强方式、时间信号强度曲线(TIC)等MRI影像学特征进行回顾性分析。结果 8例患者均以乳腺肿块就诊,多单侧发病,边界多不清晰,部分病例伴有患侧乳腺皮肤红肿及腋窝淋巴结肿大。6例病灶在T1WI上呈等信号,2例呈低信号;8例在脂肪抑制T2WI及DWI上为高信号,增强后病变形态表现为肿块样分布强化(3例)和非肿块样分布强化(5例)。病灶内部强化表现为均匀强化(3例)、厚壁环形强化(2例)和薄壁环形强化3例。病灶边缘清晰3例,边界欠清5例。TIC曲线中,4例Ⅰ型,2例Ⅱ型,2例Ⅲ型。其中2例病灶被误诊为乳腺癌。结论 GM临床表现缺乏特异性,与乳腺MRI表现相结合有助于准确诊断,能够为临床治疗提供依据。
Objective To investigate the features of magnetic resonance imaging (MRI) of chronic granulomatous mastitis (GM) and to improve the diagnostic accuracy of the disease. Methods The clinical data of 8 patients with pathologically confirmed GM collected from January 2012 to October 2015 in our hospital were retrospectively reviewed. The MRI features of lesion morphology, signal, dynamic enhancement and time signal intensity curve (TIC) were reviewed Sexual analysis. Results 8 patients were treated with breast lumps, more unilateral disease, the border is not clear, in some cases accompanied by ipsilateral breast skin and axillary lymph nodes swelling. Six lesions showed equal signal on T1WI and two showed low signal. Eight of them showed high signal on fat-suppressed T2WI and DWI. The pathological changes were enhanced by mass-like enhancement (3 cases) and non-mass-like distribution enhancement 5 cases). The internal enhancement of lesions showed uniform enhancement (3 cases), thick ring enhancement (2 cases) and thin-wall enhancement in 3 cases. Clear edge of the lesions in 3 cases, 5 cases of border clearance. TIC curve, 4 cases of type Ⅰ, 2 cases of type Ⅱ, 2 cases of type Ⅲ. Two of the lesions were misdiagnosed as breast cancer. Conclusion The lack of specific clinical manifestations of GM, combined with the performance of breast MRI help to accurately diagnose, can provide the basis for clinical treatment.