摘要
目的:探讨乳腺结节性筋膜炎(nodular fasciitis,NF)的影像学特征,提高对该疾病的诊断水平。方法:回顾并分析经手术后病理学检查证实的10例乳腺NF患者术前影像学资料,10例行超声检查,5例行乳腺X线摄影检查,3例行磁共振成像(magnetic resonance imaging,MRI)检查。结果:(1)超声:均为单发结节,最大径0.5~4.8 cm,平均(1.7±1.3)cm。6例位于皮下浅筋膜层,3例位于乳腺腺体,1例位于胸大肌肌层,均呈水平位生长。8例内部为均匀低回声,2例为不均匀回声;8例边界模糊不清,2例边界清晰;10例后方均无声影,1例后方回声增强,3例可见高回声晕。8例Adler血流为0级,2例为1级。(2)乳腺X线摄影:4例表现局部腺体结构扭曲,呈不规则斑片状致密影,其中1例局部皮肤增厚、凹陷;1例表现为浅筋膜层的类圆形结节影。(3)MRI:2例位于浅筋膜,1例位于腺体内。3例均表现为结节影,2例边缘毛糙伴毛刺,1例边缘清楚,弥散加权成像(diffusion-weighted imaging,DWI)呈不均匀高信号,表观弥散系数(apparent diffusion coefficient,ADC)为1.11~1.35×10^(-3)mm^(2)/s;增强扫描后早期不均匀强化,动态增强扫描时间-信号强度曲线(time-intensity curve,TIC)呈流入-平台型(Ⅱ型),1例皮肤增厚、凹陷。结论:对于乳腺NF的影像学诊断,超声和MRI优于乳腺X线摄影,有助于显示其病变特征。
Objective:To investigate the imaging features of nodular fasciitis(NF)of the breast and improve the diagnostic accuracy.Methods:The preoperative imaging data of 10 patients with NF of the breast confirmed by pathology were retrospectively analyzed.10 patients underwent ultrasound examination,5 patients underwent mammography examination and 3 patients underwent magnetic resonance imaging(MRI)examination.Results:⑴Ultrasonography:all nodules were single.The maximum diameter of the nodule ranged from 0.5 to 4.8 cm,with an average of(1.7±1.3)cm.6 cases were located in subcutaneous superficial fascial layer,3 in mammary glands and 1 in the pectoralis major muscle layer,and both grew horizontally.8 nodules were homogeneous hypoechogenicity and 2 nodules were inhomogeneous.8 cases had blurred boundary and 2 cases had clear boundary.All 10 nodules were no posterior echo attenuation,1 nodule had enhanced posterior echo,and 3 nodules had hyperechoic halo.Adler blood flow was grade 0 in 8 patients and grade 1 in 2 patients.⑵Mammography:4 cases showed distorted local glandular structure with irregular patchy dense shadow,and 1 case had local skin thickening and depression.One case presented as a rounded nodular shadow in the superficial fascia layer.⑶MRI 2 cases were located in superficial fascial layer and 1 in gland.All 3 cases presented nodule shadow,2 cases had rough edges with burrs,1 case had clear edge,diffuse-weighted imaging(DWI)showed uneven high signal,apparent diffusion coefficient(ADC)was 1.11-1.35×10^(-3)mm^(2)/s.At enhanced imaging,the early uneven enhancement was observed.The time-intensity curve(TIC)presented inflow-plateau type(typeⅡ),and skin thickened and depressed in 1 case.Conclusion:For the diagnosis of NF of the breast,ultrasound and MRI are better than mammography,which is helpful to display the characteristics of the lesion.
作者
沈德娟
孙骏
SHEN Dejuan;SUN Jun(Department of Ultrasound,Northern Jiangsu People’s Hospital,Yangzhou 225001,Jiangsu Province,China;Department of Medical Imaging,Northern Jiangsu People’s Hospital,Yangzhou 225001,Jiangsu Province,China)
出处
《肿瘤影像学》
2022年第6期586-590,共5页
Oncoradiology
基金
扬州市科技发展计划重点研发项目(社会发展)(YZ2021069)。
