钼靶X线影像对乳腺疾病的诊断价值

Value of Mammography X-ray Images in Diagnosing Breast Diseases

目的探讨乳腺钼靶X线影像的临床应用价值与限度。资料与方法回顾性分析71例经手术病理证实为乳腺疾病患者的钼靶X线影像资料,进行BI-RADS分类、乳腺腺体类型分型,观察病灶位置、大小、有无细钙化,与手术记录及术后病理结果进行比较。结果钼靶X线影像资料BI-RADS分类:0类13例,Ⅰ类7例,Ⅱ类3例,Ⅲ类4例,Ⅳ类28例,Ⅴ类16例。BI-RADS分类与术后病理结果比较,Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ类的诊断符合率分别为28%、33%、75%、60%、100%。乳腺钼靶X线影像资料有28例(39%)对病灶位置评估不准确,37例(52%)对病灶大小评估不准确;11例有细钙化影,其中9例为乳腺癌。致密型和中间混合型乳腺占77%(55/71),与术后病理相比,钼靶X线诊断准确率为53%;退化型乳腺占23%(16/71),与术后病理相比,钼靶X线诊断准确率为81%。结论乳腺钼靶X线对于乳腺疾病的显示有一定价值,但对于病灶诊断准确率低,特别是致密型乳腺,对于病灶的位置及大小显示不准确。

Purpose To discuss the clinical value and limitations of mammography X-ray photography in diagnosis of breast diseases. Materials and Methods Mammography X-ray image data of 71 cases with pathologically confirmed breast diseases were retrospectively analyzed. The BI-RADS categorization, lesion location, lesion size, micro calcification and mammary gland type were analyzed and compared with surgical records and pathologic results. Results The BI-RADS classification of 71 mammography data were： 13 cases of category 0, 7 cases of categoryⅠ, 3 cases of category Ⅱ, 4 cases of category Ⅲ , 28 cases of category Ⅳ , and 16 cases of category Ⅴ . The coincidence rate of categoryⅠ, Ⅱ, Ⅲ , Ⅳ and Ⅴ were 28%, 33%, 75%, 60% and 100%, respectively. Assessment of the lesion location on mammography was not accurate for 28 cases （39%）, and inaccurate assessment of lesion size for 37 cases （52%）. Fine calcification had been found in 11 cases, and 9 of them were breast cancer. Dense and intermediate hybrid glands accounted for 77% （55/71）, and the correct diagnostic rate of mammography was 53%. Degenerate glands accounted for 23% （16/71）, and the correct diagnostic rate of mammography was 81% when compared with surgical pathology. Conclusion The mammography X-ray is useful in detecting breast diseases, but has a low accuracy for diagnosing lesions of dense glands, which is not accurate to detect lesion location and size.