增强数字X线摄影对乳腺癌的诊断价值

The clinical value of contrasted X-ray in diagnosis of breast carcinoma

目的 评估乳腺良恶性病灶的数字X线增强形态对乳腺良恶性病变的鉴别诊断价值。方法 对29例经手术病理证实的乳腺疾病患者行数字X线常规和增强检查。比较乳腺良恶性病变的X线征象,包括形态学、内部密度及其X线增强特征等。结果 29例患者共计病灶31个,其中恶性26个,良性5个。乳腺良性病变多呈类圆形或分叶状,边缘光整、无毛刺,边界多清晰,强化均匀或伴有内部分隔等;恶性病变则多为不规则形,边缘可伴毛刺,与周围结构分界不清,强化不均匀,病灶常呈环形强化,导管样强化。良恶性病变边缘形态分布差异有统计学意义（χ2=26.43,P＜0.05）。病灶增强形态诊断的敏感性为83.8%（26/31）,特异性为76.9%（20/26）。结论 乳腺数字X线常规摄影可提供病灶的形态学信息,而增强数字X线揭示病变的血流动力学特征,从而有助于对乳腺病变作出准确的定性诊断,更有效地鉴别诊断乳腺良恶性病变。

Objective To evaluate the clinical value of contrasted X-ray in diagnosis of breast lesions.Methods 29 patients who were confirmed as breast lesions verified by surgery and histopathology were enrolled in this study.All the lesions were evaluated by plain and contrasted X-ray.The lesion detectability of X-ray,and contrasted series.Results 29 patients had 26 malignant and 5 benign lesions.There were significant differences between benign and malignant tumors on enhancement homogenity,morphology and margin characteristics.According to the morphology character and enhancement pattern.The distribution proved significantly different（χ2=26.43,P＜0.05）.The diagnostic indices for the lesions morphology had the sensitivity of 83.8%（26/31） and specificity of 76.9%（20/26）.Conclusion Enhanced X-ray was better than plain exam on lesion detection.Benign and malignant breast tumors could be differentiated according to the morphology characteristic and enhancement pattern.