CAJ | 학술논문

目的探讨不同病理类型乳腺肉芽肿性疾病的超声特征及诊断可行性分析.方法回顾性分析2008年11月至2012年11月浙江大学邵逸夫医院32例不同病理类型的乳腺肉芽肿性疾病的临床表现、声像图特征和超声诊断信息,为辅助诊断乳腺肉芽肿性疾病提供依据.结果依据32例乳腺肉芽肿性病例,其超声特征可分为4型:管样型、肿块型、弥漫型和囊肿型.其中12例肉芽肿性乳腺炎和12例未分类的肉芽组织增生以管样型(6、5例)为主,其次为肿块型(4、5例)和弥漫型(各2例);5例黄色肉芽肿、2例脂性肉芽肿和1例异物肉芽肿,除1例脂性肉芽肿为囊肿型外,其余均表现为肿块型.肉芽肿性乳腺炎和炎性肉芽组织增生这两组病例诊断准确率较高,超声下以炎症作为第一诊断的比例分别为10/12和8/12,而诊断为BI-RADS 4b及以上的均只有1例,分别为8.3％.黄色肉芽肿和异物肉芽肿超声下被误诊为癌概率则很高,BI-RADS 4b及以上误诊比例分别为4/5和1/1.结论超声诊断肉芽肿性乳腺炎和炎性肉芽组织增生具有一定的实用价值,但确诊依靠病理学检查结果.
목적 탐토불동병리류형유선육아종성질병적초성특정급진단가행성분석.방법 회고성분석2008년11월지2012년11월절강대학소일부의원32례불동병리류형적유선육아종성질병적림상표현、성상도특정화초성진단신식,위보조진단유선육아종성질병제공의거.결과 의거32례유선육아종성병례,기초성특정가분위4형:관양형、종괴형、미만형화낭종형.기중12례육아종성유선염화12례미분류적육아조직증생이관양형(6、5례)위주,기차위종괴형(4、5례)화미만형(각2례);5례황색육아종、2례지성육아종화1례이물육아종,제1례지성육아종위낭종형외,기여균표현위종괴형.육아종성유선염화염성육아조직증생저량조병례진단준학솔교고,초성하이염증작위제일진단적비례분별위10/12화8/12,이진단위BI-RADS 4b급이상적균지유1례,분별위8.3％.황색육아종화이물육아종초성하피오진위암개솔칙흔고,BI-RADS 4b급이상오진비례분별위4/5화1/1.결론 초성진단육아종성유선염화염성육아조직증생구유일정적실용개치,단학진의고병이학검사결과.
Objective To evaluate the sonographic features of different pathological types of breast granulomatous diseases and analyze the feasibility of ultrasonic diagnosis.Methods A total of 32 patients with different pathological types of breast granulomatous diseases were recruited.Their clinical and sonographic findings were retrospectively reviewed.There were granulomatous mastitis (n =12),breast xanthogranuloma (n =5),lipogranuloma (n =2),foreign body granuloma (n =1) and nonspecific granulation hyperplasia (n =12).Results Based on major sonographic appearances,they were divided into 4 patterns of tubular,mass,diffuse and cystic mass.In 12 patients with granulomatous mastitis and 12 patients with nonspecific granulation hyperplasia,the major sonographic appearance was of tubular pattern (n =6,5),followed by mass pattern (n =4,5) and diffuse pattern (n =2,2).Five patients with breast xanthogranuloma and 1 patient with foreign body granuloma all showed mass pattern.In 2 patients with lipogranuloma,one was of mass pattern and abother cystic pattern.In patients with granulomatous mastitis and patients with nonspecific granulation hyperplasia,it showed a high diagnostic reliability of ultrasound.The ratio of inflammatory lesion as the first sonographic diagnosis was 10/12 and 8/12 respectively and ultrasonic BI-RADS 4b or above both only 1/12.However,the ratio of sonographic imaging in patients with xanthogranuloma and Lipogranuloma mimic breast cancer,in which ultrasonic score as breast imaging-reporting and data system (BI-RADS) 4b or above was 4/5 and 1/1 respectively.Conclusions Ultrasound is valuable in evaluating the lesions in patients with granulomatous mastitis and nonspecific granulation hyperplasia.However a definite diagnosis is still dependent on histopathology.