探讨乳腺（侵袭性）纤维瘤病（BF）的临床特征和影像学表现。

收集2015年1月至2025年8月在南京医科大学第一附属医院行超声检查并经病理证实为BF的39例患者（共48个病灶）的临床资料。回顾性分析其临床、超声、钼靶及MRI特征。

BF患者年龄为（30.7±9.4）岁，病灶最大径为（27.6±17.8）mm。10例患者术后随访超声或MRI检查提示复发。超声检查特征：BF病灶多位于腺体层（33/48，68.8%），以非肿块型为主（31/48，64.6%）。病灶多呈不规则低回声（40/48，83.4%），内部回声多均匀（45/48，93.8%），边界清晰（29/48，60.4%），边缘毛刺或成角常见（42/48，87.5%），钙化罕见（1/48，2.1%），后方回声多无改变（44/48，91.7%），Adler血流分级多为1级（24/48，50.0%）或2级（20/48，41.7%），弹性成像评分多为3分（16/35，45.7%）或4分（17/35，48.6%）。超声造影后病灶多呈不均匀增强（5/6，83.3%），内部不增强或低增强，周边增强明显。钼靶检查特征：BF多呈类圆形高密度结节影（12/23，52.2%），少数表现为腺体结构纠集（4/23，17.4%）或不规则肿块伴毛刺（4/23，17.4%）。共27个BF病灶行MRI检查，其中肿块型病灶17个，多呈不规则形态（10/17，58.8%），增强后均匀强化（11/17，64.7%）；而非肿块型BF（10个病灶）则表现为边界不清的非肿块样强化（10/10，100%）。MRI动态增强时间-强度曲线以渐增型为主（20/27，74.1%），表观弥散系数值为（1.16±0.22）×10^-3 mm²/s。

BF具有一定的临床和影像学特征，超声、MRI和钼靶3种检查手段互补，可为BF临床诊治提供重要的参考信息。

To explore the clinical and imaging features of breast fibromatosis (BF).

Clinical data of 39 patients (with a total of 48 lesions) who underwent ultrasound examination and were pathologically confirmed as having BF in the First Affiliated Hospital with Nanjing Medical University from January 2015 to August 2025 were collected. A retrospective analysis was performed on the clinical, ultrasound, mammographic, and MRI data.

The mean age of BF patients was (30.7±9.4) years, and the mean maximum diameter of the lesions was (27.6±17.8) mm. Among the patients who were followed up, 10 cases showed signs of recurrence after surgery, as indicated by ultrasound or MRI. On conventional ultrasound, BF lesions were mainly located in the glandular layer (33/48, 68.8%), and were predominantly of non-mass type (31/48, 64.6%). Most lesions presented as irregular hypoechoic lesions (40/48, 83.4%), with typically homogeneous internal echoes (45/48, 93.8%), clear boundaries (29/48, 60.4%), frequent spiculated or angular margins (42/48, 87.5%), rare calcifications (1/48, 2.1%), and mostly no change in posterior echoes (44/48, 91.7%). The Adler blood flow grade was typically grade 1 (24/48, 50.0%) or grade 2 (20/48, 41.7%). On elastography, BF lesions commonly scored 3 (16/35, 45.7%) or 4 (17/35, 48.6%). On contrast-enhanced ultrasound (CEUS), most BF lesions presented as heterogeneous enhancement (5/6, 83.3%), with absent or minimal internal enhancement and prominent peripheral rim enhancement. Mammographic examination showed that BF mostly appeared as round-like high-density nodules (12/23, 52.2%), while a minority presented as glandular structure retraction (4/23, 17.4%) or irregular masses with spiculation (4/23, 17.4%). A total of 27 lesions underwent MRI, among which 17 were mass-type lesions, most of which exhibited an irregular shape (10/17, 58.8%) and showed homogeneous contrast enhancement (11/17, 64.7%). In contrast, non-mass-type BF (10 lesions) manifested as ill-defined non-mass-like enhancement (10/10, 100%). The time-intensity curves on dynamic contrast-enhanced MRI were predominantly of the progressive type (20/27, 74.1%), and the apparent diffusion coefficient was (1.16±0.22)×10^-3 mm²/s.

BF exhibits certain clinical and imaging characteristics. The three imaging modalities—ultrasound, MRI, and mammography—are complementary to each other, providing important reference information for the diagnosis and treatment of BF.