【摘要】 目的 总结非哺乳期乳腺炎（NPM）的MRI特征并进行分型,以提高对NPM认识。方法 回顾性分析43例52个经活检或手术证实的NPM病灶,以MRI多模态检查方法分析其DW、T₁、WI、T₂ WI和动态增强扫描特征,对时间-信号曲线（TIC）类型进行计数分析、ADC值进行计量分析,结合临床资料,分为典型NPM和不典型NPM 2种类型。结果 52个病灶中,32个病灶确定为典型NPM,20个病灶诊断为非典型NPM。典型NPM同时具备3个特征:（1）DWI高信号部分不强化（环形强化）提示脓肿形成;（2）T₂WI显示乳头、乳晕、皮肤和乳后间隙水肿或增厚,其中皮肤受累包括窦道形成;（3）大部分病例为产后,无明显红肿热痛或白细胞升高。20个非典型NPM强化的形态特征、TIC类型、ADC值缺乏特异性。结论 在MRI上将NPM划分为典型和不典型2种类型,有助于临床明确诊断,对典型NPM可直接进行治疗,不典型NPM的MR征象缺乏特异性,需穿刺活检明确后进行治疗。更多还原

【Abstract】 Objective To summarize MRI features and classification of non-puerperal mastitis（NPM）,to improve the diagnostic efficacy of NPM.Methods 43 cases（52 lesions） of NPM confirmed by biopsy or operation were analyzed retrospectively.The characteristics of MRI sequences（DWI,T₁WI,T₂WI and dyriamic contrast enhancement） of 52 lesions of NPM were observed,combined with clinical data,and divided into two types,typical and atypical types.Results 32 of 52 lesions were identified as typical NPM and 20 atypical NPM.Typical NPM showed all three characteristics:（1）On DWI,central high signal was found,which was corresponding to non-enhanced area on DCE and indicating abscess（edge ring enhancement）.（2） On T2WI,the nipple,areola skin and the retro-mammary space showed swelling or thickening,including the sinus tract caused by skin involvement.（3）Most of cases were postpartum with no obvious swelling,heat,pain or leukocyte elevation.The morphological characteristics,time intensity curve（TIC） types,ADC values and enhancement findings were not specific in 20 atypical NPM.Conclusion NPM can be classified into typical and atypical types on MRI,which can help clinical diagnosis and direct treatment of typical NPM.Atypical NPM on MR is lack of specificity,which treatment should be carried out after biopsy clear.更多还原