乳腺浸润性导管癌的钼靶X线诊断与病理对照分析

AN ANALYSIS OF 35 CASES OF INFILTRATED MAMMO-DUCTAL CARCINOMA BY COMPARING DIAGNOSTIC DISCOVERY OF MOLYBDENUM TARGET X-RAY SET WITH PATHOLOGICAL CHANGES

目的:通过对乳腺浸润性导管癌钼靶X线表现与病理学对照分析,提高乳腺导管癌影像诊断水平。方法:常规摄双侧乳腺轴位(CC位)及侧斜位(MLO位)摄片、并经手术及病理证实的乳腺浸润性导管癌35例,结合病理学结果及文献报导,综合分析X线特征。结果:主要征象:单纯肿块型17例(49%);钙化伴肿块9例(26%);钙化为主型6例(17%),其中单纯钙化2例,钙化并结构扭曲4例;局限致密浸润2例;单纯结构扭曲1例。次要征象:毛刺征18例(占肿块型的67%);彗星尾征4例,恶性晕环征5例,卫星灶2例,阳性导管征6例;乳头凹陷6例;皮肤增厚11例;酒窝征5例;血运丰富10例;腋下淋巴结肿大14例。特殊征象:肿块长径或病变生长趋势沿导管走行者11例(占肿块的42%);钙化分布范围位于同一象限者13例(占钙化的87%),其中钙化整体走行呈V型或向乳头区方向者11例(73%);钙化的形态表现为细线样、分支状或大小不等的多形性者10例(67%)。结论:浸润性导管癌X线表现以边缘毛刺伴或不伴钙化的肿块为主,肿块的走向、钙化灶的形态、分布趋势及结构扭曲等征象对浸润性导管癌的诊断具有指导性意义,对提高诊断有重要价值。

Objective ：To raise the level of mol-target X-ray diagnosis through comparing the X-ray findings with the pathological changes. Methods：X-ray films at C：C position and MLO position were taken routinely of both mammae of 35 cases of mammo-ductal carcinoma,which were confirmed by operation or pathological examination later,With the help of literature and pathological appearances,a comprehensive analysis about the specialities shown by X-ray films were carried out. ResultS：Major signs： Simple tumor 17 cases （49%）,tumor with calicification 9 cases （26%）;califications as mian part 6 cases （17%）,in which simple calicification 2 cases, calcification with twist of contruction 4 cases;local condenced infilitration 2 cases,simple twist of construction 1 cases. Minor signs： Comedo appearance 18 cases （accounting for 67% of the tumor type）;comet-tail 4 cases; malignant halo 5 cases;satellite type 2 cases;positive duct sign 6 cases;retraction of the nipple 6 cases;orange-peel skin 11 cases;dimple sign 5 cases;profuse blood ciriculation 10 cases;axillary lymphadeno hypertrophy 14 cases. Special signs： Tumor developing along the duct 11 cases （accounting for 42% of the tumor type）;calcification area situated in the same quadrant 13 cases （accounting for 87% of the calicification cases）,in which the direction of calicification showing a ＂V＂ figure or pointing to the nipple 11 cases （73%）;calicification thread like,brancheslike,or with different sizes and different forms 10 cases （67%）. Conclusion：X-ray appearances of filtrated mammo-ductal carcinoma are mainly marginal comedo tumor with or without calicification. The direction of the development of the tumor,the type of calicification,the spreading direction and the construction twists are all of guiding significance in diagnosing an infiltrated mammo-ducal carcinoma,and of great value to improve our diagnostic accuracy.