乳腺良恶性病变的CT鉴别诊断

Differential diagnosis between benign and malignant breast lesions with computed tomography

目的评价多层螺旋CT在鉴别乳腺良恶性病变中的应用价值。方法 22例经手术或病理组织学证实的乳腺疾病患者,其中,恶性肿瘤14例(8例乳腺癌,3例导管癌及3例浸润癌)和良性病变8例(2例乳腺增生,4例乳腺纤维瘤,1例乳腺炎及1例男性乳房发育异常)均经16层螺旋CT(MSCT)扫描。4例又经对比增强CT扫描。对所有患者的CT表现进行了回顾性分析。结果 CT扫描证实,乳腺癌性病灶表现为不规则形肿块伴周边毛刺,病灶内钙化,局部皮肤凹陷,乳头内陷,腋窝淋巴结肿大。乳腺增生表现为乳腺组织中致密影,密度等同于周围腺体。乳腺纤维瘤表现为圆或椭圆形边缘光滑的肿块影,密度均匀,部分病灶有强化。乳腺炎表现为片状不规则致密影,边缘模糊,内见低密度脓肿形成。结论多层螺旋CT在乳腺良恶性病变的鉴别诊断中起重要作用。

Objective To evaluate the applied value of multislice spiral computed tomography（MSCT） for differentiating benign from malignant breast lesions.Methods Twenty-two patients with surgically or histopathologically proved breast lesions which comprised 14 malignant lesions（8 breast cancers,3 breast intraductal carcinomas and 1 infiltrating carcinoma） and 8 benign lesions（2 hyperplasia,4 fibromas,1 mammitis and 1 male mammogenic dysplasia） underwent conventional CT scans.Four patients underwent contrast-enhanced CT scans.The CT findings of all patients were analyzed retrospectively.Results CT scans demonstrated that breast cancerous lesions appeared as irregular mass shadows with spiculated margin,intralesional calcification,local skin indentation,crater nipple,and axillary lymphadenovarix;breast hyperplasia appeared as intramammary dense shadows with isodensity equal to peripheral gland bodies;breast fibroma appeared as round or oval mass shadows with smooth margin,homogeneous density,and enhancement of part lesions;mammitis appeared as patchy and irregular dense shadows with ill-defined margin,and intralesional abscess formation with hypodensity.Conclusion MSCT plays important role in the differential diagnosis between benign and malignant breast lesions.