Oh K K, Kim J H, Kook S H
Department of Diagnostic Radiology, Yonsei University College of Medicine, Yongdong Severance Hospital, Seoul, South Korea.
Eur Radiol. 1998;8(8):1475-80. doi: 10.1007/s003300050578.
The aim of our study was to evaluate radiologic findings of the tuberculosis involving breast. We evaluated the radiologic features of 17 patients (18 lesions) with tuberculous disease involving the breast. The radiologic examinations, including mammography (16 patients), ultrasonography (12 patients), and Gd-DTPA-enhanced dynamic MRI (6 patients), were analyzed. Mammographic findings included mass (12 of 17 lesions), calcification (3 of 17 lesions), asymmetric density with spiculated margin (5 of 17 lesions), and axillary lymph node enlargement (8 of 17 lesions). On ultrasonography, a smooth bordered mass (7 of 13 lesions) with thin boundary (7 of 13 lesions) and heterogeneous, intermediate internal echoes (9 of 13 lesions) were most commonly demonstrated. On Gd-DTPA-enhanced dynamic MRI, 3 lesions showed significant enhancement at the first minute after injection (3 of 7 lesions). The maximum enhancing amount was greater than 500 normalized units, and the enhancing pattern was smooth or irregular ring appearance. Breast involvement with tuberculosis is rare but should be considered in the differential diagnosis of a woman living in an endemic area or when extramammary foci of tuberculosis are present. A multimodality imaging approach with clinical evaluation will help to establish the diagnosis of tuberculosis involving breast.
我们研究的目的是评估乳腺结核的影像学表现。我们评估了17例（18个病灶）患有乳腺结核疾病患者的影像学特征。对包括乳腺X线摄影（16例患者）、超声检查（12例患者）和钆喷酸葡胺增强动态磁共振成像（6例患者）在内的影像学检查进行了分析。乳腺X线摄影表现包括肿块（17个病灶中的12个）、钙化（17个病灶中的3个）、边缘有毛刺的不对称密度影（17个病灶中的5个）以及腋窝淋巴结肿大（17个病灶中的8个）。超声检查时，最常显示的是边界光滑的肿块（13个病灶中的7个），边界薄（13个病灶中的7个），内部回声不均匀、中等（13个病灶中的9个）。在钆喷酸葡胺增强动态磁共振成像上，3个病灶在注射后第一分钟显示明显强化（7个病灶中的3个）。最大强化量大于500归一化单位，强化模式为光滑或不规则环形。乳腺结核累及较为罕见，但对于生活在流行地区的女性或存在乳腺外结核病灶时，在鉴别诊断中应予以考虑。采用多模态成像方法并结合临床评估将有助于确立乳腺结核的诊断。
