炎性乳癌与乳腺炎的超声诊断及鉴别

[目的]总结炎性乳癌与乳腺炎的声像图特征,提高其术前诊断的准确性.[方法]通过对临床病理证实的5例炎性乳癌、102例乳腺炎的声像图及临床资料进行回顾性分析,总结其声像图特征.[结果]5例炎性乳癌皮下脂肪层增厚,皮下脂肪层内淋巴管扩张而形成＂卵石状＂征象,腺体层内低回声肿块、后方回声衰减,血流丰富、分布杂乱,其中4例腋窝淋巴结肿大、2例肿大淋巴结边界不整;102例乳腺炎腺体层内高回声肿块、后方回声无衰减,血流丰富、分布规则,其中75例腋窝淋巴结肿大并边界整齐.[结论]根据声像图特征及其临床表现,炎性乳癌及乳腺炎术前能够得到正确诊断.超声检查应作为炎性乳癌及乳腺炎的首选影像学检查方法.

Differential Diagnosis of Inflammatory Breast Cancer and Mastitis with Sonography

[Objective] To summarize the sonographic features of inflammatory breast cancer and mastitis to improve the accuracy of preoperative diagnosis. [Methods]Ultrasonography and clinical data were retro- spectively analyzed in 5 cases of inflammatory breast cancer and 102 cases of mastitis confirmed by clinical pathology. Theirs sonographic characteristics were summarized. [Results]Subcutaneous fat incrassation and lymph vessel dilatation were found in 5 cases of inflammatory breast cancer, which formed ＂cobble sign＂. Hypoechoic masses with attenuation of rear echoes and rich-irregular blood flow were found in gland layer. Lymphadenovarix in the axillae was found in 4 cases of inflammatory breast cancer. Lymphadenovarix in the axillae were irregular in 2 cases of inflammatory breast cancer. Hyperechoic masses with non-attenuation of rear echoes and rich regular blood flow were found in 102 cases of mastitis. Lymphadenovarix in the axillae were regular in 75 cases of mastitis. [Conclusion]According to ultrasonographic features and clinical manifestations, inflammatory breast cancer and mastitis can be correctly diagnosed before surgery. Ultrasonography should be used as the first imaging examination of inflammatory breast cancer and mastitis.