CAJ | 학술논문

目的：探讨常规超声联合实时组织弹性成像（ RTE）对特发性肉芽肿性乳腺炎（ IGM）的诊断价值。方法收集2011年1月-2014年1月于广东省人民医院经手术病理证实的34例IGM患者的相关临床资料，分析其常规超声声像图特征、超声弹性成像评分和应变率比值（ B/A）结果。结果 IGM常规超声声像图：管样型13例，团块型18例，弥漫型3例，内可及管状低回声，边缘成角多圆钝，8例病灶内探及液性无回声区，7例出现“假肾征”，20例伴有同侧腋窝淋巴结肿大；彩色多普勒血流显像（ CDFI）示血供0级4例，Ⅰ级18例，Ⅱ级8例，Ⅲ级4例，血管走行自然，多位于病灶边缘或与病灶表面平行，中心血供稀疏；收缩期峰值流速（PSV）6~19 cm/s，阻力指数（RI）0.53~0.82，平均（0.70依0.11）。RTE：29个IGM病灶评分≤3分，5个IGM病灶评分≥4分；31个IGM病灶B/A<3.08，3个IGM病灶B/A≥3.08，平均值为（2.29依0.38）。结论 IGM的常规超声声像图具有一定特征，而超声弹性成像评分法和B/A测量技术在乳腺良恶性病灶的鉴别诊断中有较高价值，联合二者有助于提高 IGM 的术前诊断准确率。
목적：탐토상규초성연합실시조직탄성성상（ RTE）대특발성육아종성유선염（ IGM）적진단개치。방법수집2011년1월-2014년1월우광동성인민의원경수술병리증실적34례IGM환자적상관림상자료，분석기상규초성성상도특정、초성탄성성상평분화응변솔비치（ B/A）결과。결과 IGM상규초성성상도：관양형13례，단괴형18례，미만형3례，내가급관상저회성，변연성각다원둔，8례병조내탐급액성무회성구，7례출현“가신정”，20례반유동측액와림파결종대；채색다보륵혈류현상（ CDFI）시혈공0급4례，Ⅰ급18례，Ⅱ급8례，Ⅲ급4례，혈관주행자연，다위우병조변연혹여병조표면평행，중심혈공희소；수축기봉치류속（PSV）6~19 cm/s，조력지수（RI）0.53~0.82，평균（0.70의0.11）。RTE：29개IGM병조평분≤3분，5개IGM병조평분≥4분；31개IGM병조B/A<3.08，3개IGM병조B/A≥3.08，평균치위（2.29의0.38）。결론 IGM적상규초성성상도구유일정특정，이초성탄성성상평분법화B/A측량기술재유선량악성병조적감별진단중유교고개치，연합이자유조우제고 IGM 적술전진단준학솔。
Objective To explore the diagnostic value of conventional ultrasonography combined with real-time tissue elastography(RTE)for the idiopathic granulomatous mastitis(IGM). Methods Data of 34 cases of IGM confirmed by surgical pathology in Guangdong General Hospital from January 2011 to January 2014 were collected,and the conventional ultrasonic ul-trasonographic features,ultrasound elasticity imaging score and result of the B/A were analyzed. Results There were three types of IGM in conventional ultrasonic:13 cases were tube types,18 cases were mass types,3 cases were diffuse types,which fea-tured in low echo,and the edge angle was more obtuse. There was liquidity anechoic area in 8 cases," pseudo-kidney sign" in 7 cases,and ipsilateral axillary lymph node enlargement in 20 cases. CDFI showed that 4 cases were 0 class of blood supplying, 18 cases were Ⅰclass,8 cases wereⅡclass,and 4 cases wereⅢclass,and the blood vessels ran naturally,which were loca-ted in the margin of the lesion or parallel with the focal surface,lacking blood supplying in the central area;PSV 6-19 cm/s, RI 0. 53-0. 82(average 0. 70±0. 11). RTE:29 cases of IGM lesion scores were≤3,5 cases of lesion scores were≥4,and the B/A in 31 cases of IGM lesion were<3. 08,3 cases were≥3. 08,and the average value were(2. 29±0. 38). Conclusion Conventional ultrasonography of IGM has certain characteristics,and ultrasonic elasticity imaging and the B/A measurement technology have a higher value in the differential diagnosis of benign and malignant breast lesions. It will be helpful to improve the preoperative ultrasound diagnostic accuracy for IGM by combining the two methods.