检验医学与临床
檢驗醫學與臨床
검험의학여림상
JOURNAL OF LABORATORY MEDICINE AND CLINICAL SCIENCES
2015年
2期
186-187,190
,共3页
程静%唐利%张灿晶%白兰平%张晓明
程靜%唐利%張燦晶%白蘭平%張曉明
정정%당리%장찬정%백란평%장효명
非特异性肉芽肿%乳腺炎%超声声像图%误诊分析
非特異性肉芽腫%乳腺炎%超聲聲像圖%誤診分析
비특이성육아종%유선염%초성성상도%오진분석
non-specific granulomas%mastitis%sonographic%misdiagnosis analysis
目的:研究非特异性肉芽肿性乳腺炎(NGM )患者超声声像图特征以及临床误诊的原因,以此来提升临床对特异性肉芽肿性乳腺炎的诊断阳性率。方法选择2011年1月至2013年1月诊治的52例经过手术病理证实为非特异性肉芽肿性乳腺炎的超声声像图表现,对其临床资料进行分析,研究其声像图特征以及超声分型,总结其出现误诊的原因。结果非特异性肉芽肿性乳腺炎的声像图表现为3型,具体为团块、结节以及窦道管样等,其中76.9%为团块型和结节型,上述两种类型肿块边缘主要表现为蟹足征或者毛刺征,最高可达到61.5%,其中55.0%患者具有特征性表现,病灶内可见管状无回声或者小囊状无回声。23.0%的患者为窦道管样型,患者主要表现为管状低回声或者与皮肤相通的窦道。所选的患者实施超声检查与病理符合率仅仅达到30.8%,有一半被误诊为乳腺癌,尤其是窦道管样型超声容易被误诊为导管癌或者导管内瘤样变。结论对非特异性肉芽肿性乳腺炎声像图的特征进行分析,具有一定的特征性表现,再结合临床资料进行判断,能够有效提升超声诊断以及鉴别诊断水平,对临床诊断和治疗均具有显著的临床意义。
目的:研究非特異性肉芽腫性乳腺炎(NGM )患者超聲聲像圖特徵以及臨床誤診的原因,以此來提升臨床對特異性肉芽腫性乳腺炎的診斷暘性率。方法選擇2011年1月至2013年1月診治的52例經過手術病理證實為非特異性肉芽腫性乳腺炎的超聲聲像圖錶現,對其臨床資料進行分析,研究其聲像圖特徵以及超聲分型,總結其齣現誤診的原因。結果非特異性肉芽腫性乳腺炎的聲像圖錶現為3型,具體為糰塊、結節以及竇道管樣等,其中76.9%為糰塊型和結節型,上述兩種類型腫塊邊緣主要錶現為蟹足徵或者毛刺徵,最高可達到61.5%,其中55.0%患者具有特徵性錶現,病竈內可見管狀無迴聲或者小囊狀無迴聲。23.0%的患者為竇道管樣型,患者主要錶現為管狀低迴聲或者與皮膚相通的竇道。所選的患者實施超聲檢查與病理符閤率僅僅達到30.8%,有一半被誤診為乳腺癌,尤其是竇道管樣型超聲容易被誤診為導管癌或者導管內瘤樣變。結論對非特異性肉芽腫性乳腺炎聲像圖的特徵進行分析,具有一定的特徵性錶現,再結閤臨床資料進行判斷,能夠有效提升超聲診斷以及鑒彆診斷水平,對臨床診斷和治療均具有顯著的臨床意義。
목적:연구비특이성육아종성유선염(NGM )환자초성성상도특정이급림상오진적원인,이차래제승림상대특이성육아종성유선염적진단양성솔。방법선택2011년1월지2013년1월진치적52례경과수술병리증실위비특이성육아종성유선염적초성성상도표현,대기림상자료진행분석,연구기성상도특정이급초성분형,총결기출현오진적원인。결과비특이성육아종성유선염적성상도표현위3형,구체위단괴、결절이급두도관양등,기중76.9%위단괴형화결절형,상술량충류형종괴변연주요표현위해족정혹자모자정,최고가체도61.5%,기중55.0%환자구유특정성표현,병조내가견관상무회성혹자소낭상무회성。23.0%적환자위두도관양형,환자주요표현위관상저회성혹자여피부상통적두도。소선적환자실시초성검사여병리부합솔부부체도30.8%,유일반피오진위유선암,우기시두도관양형초성용역피오진위도관암혹자도관내류양변。결론대비특이성육아종성유선염성상도적특정진행분석,구유일정적특정성표현,재결합림상자료진행판단,능구유효제승초성진단이급감별진단수평,대림상진단화치료균구유현저적림상의의。
Objective To study the ultrasonographic features of nonspecific granuloma mastitis (NGM ) and the reasons for its clinical misdiagnosis in order to enhance the diagnostic positive rate of NGM in clinic .Methods 52 cases of operatively and pathologically confirmed NGM in our hospital from January 2011 to January 2013 were se‐lected and their clinical data were analyzed for researching the ultrasonographic features and the ultrasonic types .The reasons leading to misdiagnosis were summarized .Results The NGM ultrasonograms showed three types ,specifical‐ly clumps ,nodules and sinus tract tube‐like ,76 .9% of which was mass and nodular types ,their edges were mainly manifested by crab foot sign or burr sign ,which was highest up to 61 .5% ,55 .0% of which possessed the character‐istic manifestations ,the tubular echoless or small cystic echoless were seen in the lesions .23 .0% of the patients were sinus tract tube‐like type ,which was mainly manifested by the tubular hypoecho or sinus communicating with the skin .The coincidence rate of ultrasonographic examination and the pathological examination in the selected patients reached only 30 .8% ,half being misdiagnosed as breast cancer ,especially the sinus tract tube‐like ultrasonogram could be easily to be misdiagnosed as ducal carcinoma or intraductal tumor‐like change .Conclusion The analysis on the characteristics of NGM shows that NGM has a certain characteristic manifestations ,by combining with the clinical data for conducting the judgment ,which can effectively enhance the level of the ultrasound diagnosis and differential diagnosis and has the important clinical significance for the clinical diagnosis and treatment .