隐匿性乳腺病灶钼靶X线表现与病理对照研究

The comparison of mammographic and pathologic features in nonpapable breast lesion

目的分析各种隐匿性乳腺病灶钼靶X线表现,及其与病理学的相关性,为临床诊疗提供参考。方法经手术、病理证实的各种隐匿性乳腺病灶如导管原位癌、导管原位癌伴微浸润、导管内乳头状瘤、乳腺增生症、乳腺纤维瘤共122例钼靶X线表现,并与其病理结果对照。结果10例导管原位癌钼靶X线表现为细沙样簇状钙化、结节样致密影、局部结构紊乱。13例导管原位癌伴微浸润X线表现为细沙样簇状钙化、放射状的毛刺影、血管影增多、局部结构紊乱、结节性致密影。18例导管内乳头状瘤X线表现为小结节影、局限性致密影。52例乳腺增生症X线表现为局限性致密影、结构紊乱。29例乳腺纤维瘤X线表现为孤立的结节、局限性致密影。结论良、恶性隐匿性乳腺病灶的钼靶X线表现为常见的特征,恶性征象有细沙样不均质簇状浅钙化、局部结构紊乱等;良性征象有孤立的结节、局限性致密影、粗大钙化等;与相应病理学有高度相关性,在一定程度上可为临床诊疗提供参考。

Objective To analyze the mammographic features of nonpapable breast lesion and the correlation between mammographic and pathologic findings, and try to provide clinical criteria for diagnosis and treatment. Methods A retrospective study was performed to analyze mammographic features and to correlate the mammographic and the pathologic findings in 122 consecutive cases of nonpapable breast lesion including ductal carcinoma in situ （ DCIS ） , DCIS associated with small invasive foc, intraductal papilloma, atypical hyperplasia, fibroadenoma. Results There were various features in mammogram of DCIS （ 10 cases） , including clusters of sand-like calcification, poorly-demarcated nodules or regional structural irregnlaritie. 13 cases of DCIS associated with small invasive foci mammographic features include clusters of sand-like calcification, burlike nodules or regional structural irregnlaritie; 18 cases of intraductal papilloma mammographic features include small nodule, increasing local density; 52 cases of atypical hyperplasia mammographic features include increasing local density, regional structural irregnlaritie; 29 cases of fibroadenoma mammographic features include sole nodule, coarse calcification. Conclusion Benign and maligant nonpapable breast lesion have their characteristic mammographic findings. Maligant signs include clustered, pleomorphic （varying in size and shape）, fine calcification, burlike nodules or regional structural irregnlaritie. Benign signs include sole nodule, increasing local density or coarse calcification. They were closely associated with the pathologic features. To some extent, the choice of diagnosis and treatment could be based on these mammographic findings and pathologic.