Blohmer J U, Bollmann R, Chaoui R, Kürten A, Lau H U
Universitätsklinikum Charité, Frauenklinik, Humboldt-Universität zu Berlin.
Geburtshilfe Frauenheilkd. 1994 Mar;54(3):161-6. doi: 10.1055/s-2007-1023573.
Differential diagnosis distinguishing between nonpuerperal mastitis and inflammatory cancer of the breast is difficult, the conventional method being mammography. In our study, we present the typical findings gained by sonography of 16 patients with nonpuerperal mastitis. They do not differ significantly from those cases with breast cancer. From these 16 patients, 7 were additionally examined using Colour and Pulsed Wave Doppler Sonography. International literature offers little practical knowledge in this field. In the immediate surroundings of the inflammation, we were able to represent up to four arterial vessels per patient. The parameters of the flow velocity wave form of these vessels were compared to those of the vessels in the correspondent quadrant of the contralateral breast. In all cases, the maximum systolic and the minimum end diastolic velocities were higher than in the contralateral breast, giving evidence of an increased vascularity. In 6 cases, the pulsatility and resistance indices in the inflammatory vessels were lower because of a decreased peripheral resistance of the vessel. Under therapy with antibiotics or Bromocriptine, these parameters were equalized in both breasts. The model of nonpuerperal mastitis shows, that Colour and Pulsed Wave Doppler Sonography makes it possible to differentiate tumours of the breast on the basis of an analysis of their vascularity and the comparison with the parameters of the vessels in the contralateral breast. The effects of a pharmacological therapy on the vascularity of breast tumours can also be measured with this method.
鉴别诊断非产褥期乳腺炎和炎性乳腺癌很困难，传统方法是乳房X线摄影。在我们的研究中，我们展示了16例非产褥期乳腺炎患者超声检查的典型结果。这些结果与乳腺癌患者的结果没有显著差异。在这16例患者中，7例还接受了彩色和脉冲波多普勒超声检查。国际文献在该领域提供的实用知识很少。在炎症的紧邻区域，我们能够显示每位患者多达四条动脉血管。将这些血管的血流速度波形参数与对侧乳房相应象限的血管参数进行比较。在所有病例中，最大收缩期和最小舒张末期速度均高于对侧乳房，表明血管增多。在6例病例中，由于血管外周阻力降低，炎性血管中的搏动指数和阻力指数较低。在使用抗生素或溴隐亭治疗后，两侧乳房的这些参数趋于相等。非产褥期乳腺炎模型表明，彩色和脉冲波多普勒超声检查能够通过分析乳房肿瘤的血管情况并与对侧乳房血管参数进行比较来鉴别肿瘤。这种方法还可以测量药物治疗对乳房肿瘤血管的影响。
