肉芽肿性小叶性乳腺炎的MRI表现

目的:探讨肉芽肿性小叶性乳腺炎(granlomatous lobular mastitis,GLM)的MRI表现。方法:回顾性分析28例30侧经手术病理证实的GLM的MRI信号特征、动态增强曲线类型。结果:28例(30侧)GLM主要表现为乳腺皮肤水肿增厚伴脓肿,病变腺体均表现为非肿块样病灶,以区域性分布为主(22侧),部分病灶呈跳跃性4侧。T1WI为稍低、等信号,抑脂T2WI表现为不均匀的稍高信号,与正常腺体分界不清,增强扫描明显强化,减影后病灶边界清晰。病灶中可伴大小不等的薄壁脓腔形成,脓肿与皮肤连通形成瘘管,表现为"轨道征"。10例病灶向深部发展,累及乳腺后间隙,表现为乳腺后间隙模糊,见条索样、线样病灶,T1WI呈等信号,抑脂T2WI呈高信号,轻度强化。27例患侧乳房静脉增多、迂曲,包绕病灶。GLM的动态增强曲线主要以上升型(17侧)和平台型(11侧)为主。结论:MRI检查能很好地显示GLM的病变范围、病变形态,为临床手术治疗提供依据。

MRI findings of granlomatous Iobular mastitis

Objective： To explore MRI features of granulomatous lobular mastitis （GLM）. Methods： 28 patients （30 cases） with GLM confirmed by operation and pathology were retrospectively analyzed MRI signs including signal characteristics, dynamic enhancing curve,location and range,thickening draining vein. Results..GLM mainly finding included breast skin thickening with abscess,segmental or regional nonmass like lesions,some lesions displayed jumping distribution. The MRI sings of mastitis le- sions included slightly lower or isointensity signal on T1WI images and inhomogeneous hyperintensity in fat suppressed T2 WI images,and there was no clear boundary between normal glands. The enhancing mastitis lesions showed obvious and after sub- traction of lesion with clear border. Abscess stage showed many thin wail cavities with thickening draining vein;abscess broken to form fistula,and fistula stage showed ＂rail＂ sign. Inflammation mainly showed cordlike or linear blurry images in retromam- mary space involved, which was mainly isointensity signal on T1 WI and high signal fat suppression on T2 WI with mild enhance- ment. The dynamic enhancement curves of GLM were mainly type I and type II. The draining veins around the lesions thick ened. Conclusion：MRI can show the range or shape of GLM,in order to provide basis for clinical operation treatment.