摘要
目的探讨特发性肉芽肿性乳腺 炎(GM)的MRI特征及其在中西医结合诊疗 中的应用价值。方法 回顾性分析2016年 1月-2017年6月间经我院确诊且接受乳腺 MRI检查及中西医结合治疗的32例GM患者 的临床资料,总结GM的MRI影像特点,进 而评价MRI对治疗疗效观察的价值。结果 32例病灶T1WI呈等、低信号;T2WI高低混 杂信号30例,等信号2例。不规则肿块样 病灶11例,非肿块样分布21例。增强扫描 3例病灶均匀强化,29例不均匀强化,其 中病灶内部大小不等环形强化15例,结节 样、网格样强化14例。合并腋窝淋巴结肿 大18例。32例接受中西医结合治疗经临床 及MRI评定治愈16例,好转14例,进展2 例,有效率达93.75%。结论 临床上利用 MRI可以有效对GM与其他乳腺疾病进行鉴 别和诊断,而且利用MRI的图像特征能够 对GM患者的病情变化以及中西医治疗的效 果进行有效的判断,从而为临床治疗方案 的选择提供必要的参考依据,因此MRI是 诊断GM及评定临床疗效的重要检查手段。
Objective To investigate the MRI features of idiopathic granulomatous mastitis(GM) and its value in the diagnosis and treatment of integrated traditional Chinese and Western medicine. Methods The clinical data of 32 patients with GM from January 2016 to June 2017, which were confirmed by our hospital and received MRI examination of the breast and the combination of traditional Chinese and Western medicine were analyzed retrospectively, the features of GM's MRI image were summed, and the value of MRI for the observation of quality effect was evaluated. Results 32 cases of T1WI showed equal and low signal, there were 30 cases of high and low mixed signals of T2WI, 2 cases of equal signal. There were 11 cases of irregular lump like lesions, 21 cases of non - lump like distribution. Enhanced scan of 3 cases uniform strengthened, 29 cases of in homogeneous strengthened, 15 cases of ring-shaped strengthened with different size of the lesion, 14 cases of nodular, trellis strengthened. Amalgamative axillary lymph nodes were enlarged in 18 cases. 32 cases were treated by combination of traditional Chinese and Western medicine, 16 cases were cured by clinical and MRI evaluation, 14 cases were improved, 2 cases were progresses, the effective rate was 93.75%. Conclusion GM has its characteristic features on MRI, so MRI is an important means to diagnose GM and evaluate the clinical efficacy.
【关键词】肉芽肿性乳腺炎;MRI;中西医结合;价值
【中图分类号】R711.3;R445.2
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.08.024
前言
肉芽肿性乳腺炎(Granulomatous mastitis,GM)又被称为特发性 肉芽肿性乳腺炎或肉芽肿性小叶性乳腺炎,是一种非干酪样坏死、局 限于乳腺小叶、以肉芽肿为主要病理特征的慢性炎症性疾病[1-2]。近年 来GM 的发病率还呈现逐年上升趋势,由于GM没有典型的炎症临床特 征,不仅发病隐匿,超声及乳腺X线检查没有明显特征性表现,诊断较 困难,严重威胁年轻妇女的乳房健康。近年来随着MRI技术水平的提 高,使其成为当前诊断GM重要检查手段[3-4]。为此本文试对我院经病理 证实的32例GM患者的MRI特征进行回顾性分析、研究,以期望提高利用 MRI诊断GM的水平和应用效果,且为临床治疗疗效评定提供参考和依 据。现报告如下。
中国CT和MRI杂志
第16卷, 第 8 期
2018年08月
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