超声鉴别诊断肉芽肿性乳腺炎与乳腺癌

目的 探讨二维超声及CDFI鉴别实块型肉芽肿性乳腺炎和乳腺癌的价值。 方法 回顾性分析经病理学确诊的12例肉芽肿性乳腺炎和328例乳腺癌患者的二维超声及CDFI特征,比较分析其超声表现。 结果 12例肉芽肿性乳腺炎中,7例为实块型,二维超声表现为乳腺腺体内实质不均质肿块,内部低回声中可见腺体样稍强回声,呈假肾征;乳腺癌二维超声表现为实性肿块,形态不规则,纵径大于横径,内部为不均质低回声,可见砂砾样钙化,边缘不规则,可见成角、毛刺,周围见不规则、厚薄不均的恶性晕环。CDFI示实块型肉芽肿性乳腺炎血供丰富,血管分布于肿块边缘或局部;而CDFI显示穿入血管、穿入血管分支、直接血管分支及中央粗大血管是乳腺癌的特征性血管分布形式。二者血流阻力指数均偏高。 结论 实块型肉芽肿性乳腺炎和乳腺癌的二维超声和CDFI表现不同;超声对于两者的鉴别诊断有一定价值。

Ultrasonography in differential diagnosis of granulomatous mastitis and breast cancer

Objective To explore the value of ultrasonography on the differential diagnosis of solid type granulomatous mastitis and breast cancer. Methods Two-dimensional ultrasonic and CDFI manifestations of 12 patients with granulomatous mastitis and 328 patients with breast cancer confirmed by pathology were retrospectively analyzed and compared. Results There were 7 cases of solid type granulomatous mastitis, which presented as heterogeneous masses with low echoes in the internal. There were strong glandular echoes in the low echoes, presenting as pseudokidney sign. Breast cancers mainly manifested as irregular shapes, heterogeneous echoes with or without grit calcification and blurred boundaries. The tumors' longitudinal diameters were longer than transverse diameters, and irregular malignant halos were observed around the tumors. CDFI showed rich blood supply for solid type granulomatous mastitis, and the vessels distributed at the border of mass or locally. Meanwhile, perforating vessels, branches of perforating vessels, branches of direct vessels and central large vessels were characteristic vascular distribution patterns of breast cancer. The blood flow resistance indexes were high in both diseases. Conclusion There are some differences between solid type granulomatous mastitis and breast cancer in two-dimensional ultrasound and CDFI. Ultrasound has some value on the differential diagnosis of these two diseases.