CAJ | 학술논문

目的：探讨肉芽肿性乳腺炎(GM)的 MR 表现特征,提高对该病的认识。方法回顾性分析11例病理证实为 GM 患者的临床资料和 MRI 表现。结果11例 GM 中 T2 WI 呈区域性及弥漫性高信号9例(81.82%),以网状不均质改变为特征。增强扫描呈肿块样强化2例(18.18%),呈非肿块样强化9例(81.82%),非肿块样强化包括：弥漫性强化2例(18.18%),区域性强化4例(36.36%),多发区域性强化2例(18.18%),局灶性强化1例(9.09%)。增强早期不均匀强化为特征,其中6例(54.55%)可见多发簇环状强化,增强晚期信号增高并趋于均匀。时间-信号强度曲线Ⅰ型7例(63.64%),Ⅱ型3例(27.27%),Ⅲ型1例(9.09%)。病变区域 ADC值(1.82±0.17)×10-3 mm2/s,与对侧正常腺体 ADC 值差异无统计学意义(t=1.766,P >0.05)。MRI 显示伴随表现包括乳房增大,皮肤增厚,病灶周围水肿,淋巴结增大。BI-RADS 分级包括3类1例(9.09%)、4a 类5例(45.45%)、4b 类2例(18.18%)、4c 类2例(18.18%)及5类1例(9.09%),术前诊断误诊率为54.55%。结论 GM 的 MRI 表现形式多样,但有一定的特征。因其误诊率高,诊断需要结合临床综合分析。
목적：탐토육아종성유선염(GM)적 MR 표현특정,제고대해병적인식。방법회고성분석11례병리증실위 GM 환자적림상자료화 MRI 표현。결과11례 GM 중 T2 WI 정구역성급미만성고신호9례(81.82%),이망상불균질개변위특정。증강소묘정종괴양강화2례(18.18%),정비종괴양강화9례(81.82%),비종괴양강화포괄：미만성강화2례(18.18%),구역성강화4례(36.36%),다발구역성강화2례(18.18%),국조성강화1례(9.09%)。증강조기불균균강화위특정,기중6례(54.55%)가견다발족배상강화,증강만기신호증고병추우균균。시간-신호강도곡선Ⅰ형7례(63.64%),Ⅱ형3례(27.27%),Ⅲ형1례(9.09%)。병변구역 ADC치(1.82±0.17)×10-3 mm2/s,여대측정상선체 ADC 치차이무통계학의의(t=1.766,P >0.05)。MRI 현시반수표현포괄유방증대,피부증후,병조주위수종,림파결증대。BI-RADS 분급포괄3류1례(9.09%)、4a 류5례(45.45%)、4b 류2례(18.18%)、4c 류2례(18.18%)급5류1례(9.09%),술전진단오진솔위54.55%。결론 GM 적 MRI 표현형식다양,단유일정적특정。인기오진솔고,진단수요결합림상종합분석。
Objective To explore the MR features of granulomatous mastitis and to improve the diagnosis of the disease.Methods MR findings of 1 1 patients with granulomatous mastitis confirmed by pathology were retrospectively reviewed.Results Nine (81.82%)lesions showed regional or diffused hyperintensity on T2 WI with heterogeneous gridding features.2 (18.18%)lesions showed mass-like enhancement and 9 lesions showed non-mass-like enhancement.Of 9 (81.82%)lesions with non-mass-like en-hancement,the enhancement patterns included diffused in 2 (18.18%)cases,regional in 4 (36.36%)cases,multiple-regional in 2 (18.18%)cases,and focal in 1 (9.09%)case,respectively.All the lesions showed early heterogeneous enhancement,and clumped-ring enhancement was seen in 6 lesions.The signal intensity of the lesions was increased and more uniform in the later stage.The time-signal intensity curve was type I in 7(63.64%)cases,type II in 3 (27.27%)cases and type III in 1 (9.09%)case.The mean ADC value was (1.82±0.1 7)×10 -3 mm2/s,and there was no significant difference between lesions and normal regions (t=1.766, P >0.05).Concomitant signs included barymastia,thickening of skin,edema surrounding the lesions,and axillary lymph node en-largement.The BI-RADS category was 3 degree in 1 (9.09%)case,4a degree in 5 (45.45%)cases,4b degree in 2 (18.18%)ca-ses,4c degree in 2 (18.18%)cases and 5 degree in 1 (9.09%)case.The misdiagnosis ratio was 54.55%.Conclusion Granuloma-tous mastitis has certain characteristic MR features.The misdiagnosis ratio of granulomatous mastitis is high.Therefore,clinical data should be referred when making diagnosis.