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Published on: July 21, 2023
Multimodal Imaging of Diabetic Mastopathy: A 62-Case Study With Ultrasound-Based Classification and Diagnostic
Yilin Xu1, Yingxue Wang1, Xiaokang Li1
1Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China, tmucih.com.
Purpose:
The purpose of this study is to investigate the application of multimodal imaging technology in diagnosing diabetic mastopathy (DM).
Methoods:
This study retrospectively analyzed ultrasound, mammography, and MRI findings of pathologically confirmed DM from October 2014 to October 2024.
Results:
Ultrasonography was performed on all 62 patients with DM, identifying a total of 67 lesions. The ultrasound findings were classified into four types: Type I presented as a focal thickening and bulging of the gland with a mix of high and low echoes (42/67, 62.7%); Type II showed focal or overall hypoechoic areas with indistinct margins (19/67, 28.3%); Type III exhibited diffuse hypoechoicity in the lesion area, poorly visualized internal structures, and markedly attenuated posterior echoes (4/67, 6.0%); and Type IV consisted of slightly hypoechoic areas (2/67, 3.0%). The overall diagnostic accuracy of ultrasound was 58.2%. Fifty-one patients with a total of 58 lesions underwent mammography. Eighteen lesions (31.0%) were negative on mammography, whereas 32 lesions (55.2%) displayed asymmetric density. The diagnostic accuracy of mammography was 69%. Five patients with five lesions underwent MRI, which revealed nonmass-like inhomogeneous progressive enhancement, isointensity and hypointensity in T2-weighted images, insignificant or slight hyperintensity in diffusion-weighted imaging, and no significant decrease in apparent diffusion coefficient value, yielding a diagnostic accuracy of 80%.
Conclusion:
The ultrasound characteristics of DM were marked by nonmass-type lesions with distinctive echogenic and structural features. Mammography demonstrated insignificant or nonspecific asymmetric densities without suspicious calcifications or structural distortions. Breast MRI indicated nonmassive lesions exhibiting benign features based on hemodynamic parameters and diffusion-weighted imaging. The combined application of multimodal imaging enhanced diagnostic accuracy, particularly when incorporated with patient history.
