肉芽肿性乳腺炎肿块期患者超声图像特征与临床病理及中医证型分布的关系分析

Abstract
Figure/Table
References
Related Citation (13)

Download: PDF (2216 KB) HTML (0 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To explore the relationship between ultrasound image characteristics and clinicopathological staging and TCM syndrome type distribution in patients with granulomatous mastitis (GLM) in mass stage. Methods 56 patients with GLM in mass stage in the hospital were retrospectively selected from August 2022 to August 2023 and included in mass stage group. In addition, 30 patients with GLM in non-mass stage (abscess stage, post-ulcer stage) during the same time period were selected and enrolled as non-mass stage group. All patients underwent Doppler ultrasonography and were confirmed by pathology. The differences in ultrasound image characteristics (lesion size, shape, boundary, echo, calcification, catheter dilatation, blood flow signal) between the two groups were compared, and the relationship between ultrasound image characteristics and GLM in mass stage was analyzed by multivariate regression model. According to TCM syndrome types and tongue pulse conditions, the patients were divided into four syndromes: liver depression and phlegm coagulation syndrome, liver-stomach stagnation heat syndrome, phlegm-blood stasis blocking syndrome and yang deficiency and phlegm coagulation syndrome. The differences in ultrasound image characteristics were compared among patients with GLM in mass stage of different syndrome types. Results The proportions of lesions <6 cm, clear boundary, uniform echo, no calcification, no catheter dilatation and blood flow signal grade 0-I in mass stage group were significantly higher than those in non-mass stage group. Multivariate regression analysis showed that no catheter dilatation and blood flow signal grade 0-I were independent risk factors for GLM in mass stage. There was a statistically significant difference in the blood flow signal of ultrasound image among patients with different syndrome types of GLM in mass stage. The number of cases with blood flow signal grade 0-I in yang deficiency and phlegm coagulation syndrome (6 cases, 75.00%) was the highest, and the liver-stomach stagnation syndrome (2 cases, 12.50%) was the lowest. Conclusion The ultrasound image characteristics of lesion size, boundary, echo, calcification, catheter dilatation and blood flow signal in patients with different stages of GLM are different. Ultrasound images show that no catheter dilatation and blood flow signal grade 0-I are more likely to belong to GLM in mass stage. There are some differences in ultrasound blood flow signals under different TCM syndrome types of GLM in mass stage. Ultrasound blood flow signal can be used to assist the diagnosis of TCM syndrome differentiation of GLM in mass stage.

Key words： granulomatous mastitis mass stage ultrasound pathological classification TCM syndrome types

Received: 23 May 2024

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	MA Feifei
	REN Yajuan
	XU Fang
	MENG Tian

Cite this article:

MA Feifei,REN Yajuan,XU Fang等. Analysis of relationship between ultrasound image characteristics and clinicopathology and TCM syndrome type distribution in patients with granulomatous mastitis in mass stage[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(4): 59-64.

URL:

http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I4/59

[1] YUAN QQ, XIAO SY, FAROUK O, et al.Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition)[J]. Mil Med Res, 2022, 9(1): 20.
[2] 楚爱景, 樊英怡, 王春晖, 等. 肉芽肿性乳腺炎的中西医治疗现状及分析[J]. 中华中医药杂志, 2020, 35(12): 5971-5974.
[3] 邵牧民, 毕嘉欣. 肉芽肿性小叶性乳腺炎病理诊断路径[J]. 临床与实验病理学杂志, 2023, 39(9): 1042-1048.
[4] 徐娟, 刘晓璐, 赵国政, 等. 非哺乳期乳腺炎病理类型与超声表现的对比分析[J]. 中国超声医学杂志, 2021, 37(12): 1345-1348.
[5] 陈露阳, 彭书旺, 陈晓琼. 高频超声对肉芽肿性乳腺炎的诊断价值[J]. 精准医学杂志, 2020, 35(2): 150-152.
[6] 周瑶, 赵丹, 刘舒雷, 等. 基于"玄府气液-阳热怫郁"理论辨治肉芽肿性小叶性乳腺炎[J]. 中国中医基础医学杂志, 2023, 29(12): 2109-2111.
[7] 石光煜, 张雪松, 李晶, 等. 基于超微血管成像技术探讨不同中医证型乳腺癌患者的血流特征[J]. 海军军医大学学报, 2022, 43(4): 465-469.
[8] 王朝义, 宋强, 熊鑫, 等. 肉芽肿性小叶性乳腺炎诊疗进展[J]. 中国临床药理学与治疗学, 2023, 28(8): 910-917.
[9] 尉志红, 张鑫桃, 严继萍. 肉芽肿性小叶性乳腺炎的超声诊断价值[J]. 中国药物与临床, 2020, 20(17): 2860-2861.
[10] 张超杰, 胡金辉, 赵希. 肉芽肿性小叶性乳腺炎诊治湖南专家共识 (2021版)[J]. 中国普通外科杂志, 2021, 30(11): 1257-1273.
[11] 中华中医药学会乳腺病专业委员会. 肉芽肿性小叶性乳腺炎中医诊疗专家共识 (2021版)[J]. 中国中西医结合外科杂志, 2022, 28(5): 597-602.
[12] OMRANIPOUR R, VASIGH M. Mastitis, Breast Abscess,Granulomatous Mastitis[J]. Adv Exp Med Biol, 2020, 1252: 53-61.
[13] XU S, ZHU X, MIAO L, et al.Treatment of granulomatous mastitis in different stages[J]. Asian J Surg, 2022, 45(11): 2287-2288.
[14] YIN L, AGYEKUM EA, ZHANG Q, et al.Differentiation Between Granulomatous Lobular Mastitis and Breast Cancer Using Quantitative Parameters on Contrast-Enhanced Ultrasound[J]. Front Oncol, 2022, 12: 876487.
[15] 司徒红林, 井含光, 刘畅, 等. 林毅运用"燮理阴阳, 立法衡通"中医综合疗法辨治肉芽肿性乳腺炎[J]. 广州中医药大学学报, 2020, 37(10): 1999-2003.
[16] 张董晓, 陈雯, 付娜, 等. 燕京外科流派分期外治肉芽肿性乳腺炎经验总结[J]. 现代中医临床, 2023, 30(6): 105-108+112.
[17] 张普, 陈震霖, 陈羽佩, 等. 论肉芽肿性乳腺炎的因机证治[J]. 陕西中医, 2022, 43(1): 97-99+107.
[18] PALA EE, EKMEKCI S, KILIC M, et al.Granulomatous Mastitis: A Clinical and Diagnostic Dilemma[J]. Turk Patoloji Derg, 2022, 38(1): 40-45.
[19] 陈薇, 牛建梅, 曹云云, 等. 肉芽肿性小叶性乳腺炎超声表现与临床病理学特征分析[J]. 肿瘤影像学, 2021, 30(2): 82-85.
[20] LIMNINART N, HARVEY JA, SCHULTZ KJ, et al."What Do You Mean It's Not Cancer?" A Review of Autoimmune and Systemic Inflammatory Diseases Involving the Breast[J]. J Breast Imaging, 2021, 3(5): 612-625.
[21] 郑志燕, 唐文成, 徐伟, 等. 不同超声分型的肉芽肿性乳腺炎影像学特征分析[J]. 安徽医学, 2022, 43(11): 1309-1313.