乳腺脂肪坏死的X线表现与鉴别诊断

Mammographic manifestation and differential diagnosis of fat necrosis of the breast

目的:探讨乳腺脂肪坏死的X线诊断及其鉴别诊断,提高脂肪坏死的认识,减少误诊。方法:回顾性分析58例经病理证实的乳腺脂肪坏死的X线表现。结果:乳腺脂肪坏死根据其病因及时期X线表现多种多样:①无任何阳性X线表现9例;②脂性囊肿5例;③肿物11例;④结节2例;⑤不对称致密4例;⑥斑片影5例;⑦脂肪层内星芒状、索条状、网状影18例;⑧结构扭曲2例;⑨颗粒状、片状不规则钙化、多形性钙化2例。在多种多样的X线表现中,腺体内的脂性囊肿及皮下脂肪层内的局限星芒状、索条状、不规则网状影为脂肪坏死的特征性表现。结论:乳腺X线检查对脂肪坏死具有重要的诊断价值。认真询问病史(如外伤、手术及炎症史等),对本病有重要帮助。

Objective：To evaluate mammographic findings and differential diagnosis of fat necrosis of the breast and to improve the imaging diagnosis of the disease so as to decrease misdiagnosis.Methods：X-ray films of 58 cases of fat necrosis proved by the histologic findings were reviewed.Results：The imaging manifestations of fat necrosis of the breast varied with its etiology and state.The mammographic findings included ① No abnomal mammographic findings（n=13）;② Single and multiple lipid-cysts（n=5）;③ Masses（n=11）;④ Nodules（n=2）;⑤ Focal areas of increased density（n=4）;⑥ pieces（n=5）;⑦ Focal opacities like stars or faint reticular opacity in the subcutaneous fat layer（n=18）;⑧ Structure distortion（n=2）;and ⑨ Granulated,pieces spiculate or wide varies of calcification（n=2）.Among a wide varies of mammographic findings,lipid cyst in adenoid tissues and focal opacities like stars and irregular reticulation findings in subbcutaneous fat layer were the characteristic mammographic findings.Conclusion：The mammography is very helpful for making the diagnosis of breast necrosis.It is important to look for history of the diseas,such as trauma,operation,inflammation of the breast and so on.