Yildiz Seyma, Aralasmak Ayse, Kadioglu Huseyin, Toprak Huseyin, Yetis Huseyin, Gucin Zuhal, Kocakoc Ercan
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey. E-mail:
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Med Ultrason. 2015 Mar;17(1):39-44. doi: 10.11152/mu.2013.2066.171.rfm.
To describe the radiological findings of idiopathic granulomatous mastitis (IGM).
Radiologic findings of 30 women with histopathological diagnosis of IGM were retrospectively evaluated. All had breast feeding history. All the patients had ultrasonography (US), with 12 of them having additional Doppler US. Of 30 patients, 11 had mammography (MG) and 5 MRI.
US showed multiple irregular hypoechoic masses and collection areas with tubular connections in 25 of 30. The collection area with low-level internal echoes but without tubular connections, suggesting an abscess were seen in 2 of 30 (6.6%); a hypoechoic mass with an indistinct border in 2 of 30 (6.6%); multiple milimetric hypoechoic nodular masses in 1 of 30 (3.3%). On MG, normal findings were noted in 5 (45.4%); focal asymmetric density in 4 (36.4%), parenchymal distortion in 1 (9%) and diffuse asymmetric opacity with trabecular thickening in 1 (9%) of 30 patients. On MRI, segmental T2 hyperintensity with contrast-enhancement on T1 were seen in 4 of 5 (80%). An enhancing T2 hypointense mass with irregular margin was present in 1 of 5 (20%). Time-signal intensity curve of lesions showed slow enhancement in 1 and moderate in 4 of 5 patients.
In IGM, MG findings were nonspecific. In US, multiple irregular hypoechoic masses and collections with tubular connections with fingerlike aspects, and fistulae formation to the skin in patients with breastfeeding history suggested IGM rather than carcinoma. Due to the limited number of patients, no conclusion was reached regarding MRI of IGM.
描述特发性肉芽肿性乳腺炎（IGM）的影像学表现。
回顾性评估30例经组织病理学诊断为IGM的女性的影像学表现。所有患者均有哺乳史。所有患者均行超声检查（US），其中12例还进行了多普勒超声检查。30例患者中，11例行乳腺钼靶摄影（MG），5例行磁共振成像（MRI）。
US显示30例中有25例存在多个不规则低回声肿块及有管状连接的液性区。30例中有2例（6.6%）可见内部有低水平回声但无管状连接的液性区，提示脓肿形成；30例中有2例（6.6%）可见边界不清的低回声肿块；30例中有1例（3.3%）可见多个毫米级低回声结节状肿块。MG检查，30例中有5例（45.4%）表现正常；4例（36.4%）表现为局灶性不对称密度增高；1例（9%）表现为实质扭曲；1例（9%）表现为弥漫性不对称致密影伴小梁增粗。MRI检查，5例中有4例（80%）可见T2加权像节段性高信号，T1加权像有强化。5例中有1例（20%）可见边界不规则的T2加权像低信号强化肿块。5例患者中，1例病变的时间-信号强度曲线呈缓慢强化，4例呈中等强化。
在IGM中，MG表现不具特异性。在US检查中，多个不规则低回声肿块及有指状管状连接的液性区，以及有哺乳史患者出现通向皮肤的瘘管形成提示为IGM而非癌。由于患者数量有限，关于IGM的MRI表现未得出结论。
