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乳房磁共振成像中的皮肤和浅表组织病变。

Lesions of the skin and superficial tissue at breast MR imaging.

机构信息

Department of Radiology, Massachusetts General Hospital, 15 Parkman St, Wang ACC-240, Boston, MA 02114, USA.

出版信息

Radiographics. 2010 Nov;30(7):1891-913. doi: 10.1148/rg.307105064.

Abstract

Although numerous studies have outlined the benefits of contrast material-enhanced magnetic resonance (MR) imaging for the detection of breast parenchymal findings, the assessment of lesions of the skin and superficial tissue at breast MR imaging has largely been overlooked. Such lesions, both benign and malignant, are commonly encountered at breast MR imaging, and their detection and diagnosis are often imperative. These lesions include superficial, locally extensive, inflammatory, and recurrent breast cancers; iatrogenic changes; sebaceous cysts; and less prevalent diseases such as granulomatous mastitis and angiosarcomas, among others. As MR imaging continues to be used with increasing frequency in both the screening and diagnostic settings, these lesions will be encountered more often; consequently, a better understanding of which lesions may be ignored and which require further evaluation will become increasingly important. Frequently, MR imaging alone may not clearly indicate the cause of lesions of the breast skin and superficial tissue. However, radiologists should thoroughly assess such lesions, taking into consideration the spectrum of possible causes. Mammography, ultrasonography, consultation with clinicians or dermatologists regarding physical examination findings, and, when necessary, correlation with pathologic findings in biopsy specimens may be used in conjunction with MR imaging to establish both the importance of these lesions and their definitive diagnoses.

摘要

尽管许多研究都概述了对比增强磁共振成像(MR)在检测乳腺实质病变方面的益处,但乳腺 MR 成像中皮肤和浅表组织病变的评估在很大程度上被忽视了。这些病变包括良性和恶性的皮肤和浅表组织病变,在乳腺 MR 成像中很常见,其检测和诊断通常至关重要。这些病变包括:浅表性、局部广泛的、炎症性和复发性乳腺癌;医源性改变;皮脂腺囊肿;以及较为罕见的疾病,如肉芽肿性乳腺炎和血管肉瘤等。随着 MR 成像在筛查和诊断中的应用频率不断增加,这些病变将会更频繁地被发现;因此,更好地了解哪些病变可能被忽视,哪些病变需要进一步评估将变得越来越重要。通常情况下,MR 成像本身并不能明确提示乳腺皮肤和浅表组织病变的原因。然而,放射科医生应该全面评估这些病变,并考虑到可能的各种病因。乳腺 X 线摄影、超声检查、与临床医生或皮肤科医生就体格检查结果进行咨询,以及在必要时结合活检标本的病理结果进行相关性分析,可能与 MR 成像联合使用,以确定这些病变的重要性及其明确诊断。

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