簇状钙化对乳腺触诊阴性的良恶性病变的鉴别诊断价值

The value of clustered calcifications on mammography in the differential diagnosis of benignancy or malignancy in non-palpable breast lesions

目的:探讨簇状钙化对乳腺触诊阴性的良恶性病变的鉴别诊断价值。方法:回顾性分析62例临床触诊阴性而乳腺X线表现为簇状钙化病例的X线表现,全部病例均经术前立体定位放置导丝下手术病理证实。结果:62例簇状钙化病例中恶性病变20例,良性病变42例;恶性病变中无Ⅱ型钙化,Ⅲ型钙化5例,Ⅳ型钙化10例,Ⅴ型钙化5例;良性病变中Ⅱ型钙化20例,Ⅲ型钙化19例,Ⅳ型钙化3例,无Ⅴ型钙化病例。恶性钙化中密度均匀2例,不均匀18例;良性钙化中密度均匀35例,不均匀7例。良恶性钙化灶在形态、密集度、密度均匀性及钙化总数方面差异具有统计学意义(P<0.05),其中钙化灶的形态及密度均匀性差异具有高度统计学意义(P<0.01),而在钙化大小、密度高低、分布范围及分布形态上差异无统计学意义(P>0.05)。结论:钙化灶的形态、密集度、密度均匀性及钙化总数对鉴别诊断良恶性病变有重要价值。

Objective：To study the significance of clustered calcifications on mammography in the differential diagno- sis of benignancy or malignancy in non--palpable breast lesions. Methods： The characteristics of clustered calcifications on mammography in 62 patients with non-palpable breast lesion was retrospectively analyzed. All were surgically and patholog- ically proven with guide wire placement under stereotactic mammography before operation. Results： Of the 62 cases with clustered calcifications,there were malignant lesions （20 cases） and benign lesions （42 cases）. Among the malignant le- sions,none of them showed Type Ⅱ calcification,there were Type Ⅲ calcification （5 cases）, Type Ⅳ-calcification （ 10 ca ses） and Type Ⅴ calcification （ 5 cases）. Of the benign lesions,there were Type II calcification （20 cases） ,Type Ⅲ calcifi- cation （19 cases） ,Type IV-calcification （3 cases）, none of them showed Type V calcification. Of the malignant calcification, there were even density （2 cases）,uneven density （18 cases）;Of benign calcification,even density was showed in 35 cases, uneven density in seven cases. Significant statistical difference was existed in the morphology, concentration, evenness of density and the total number of calcification between benign and malignant lesions （P〈0.05）. While marked significant difference was existed in the morphology and evenness of density of the calcifications （P〈0.01）, no statistical difference was assessed in the size, density, extent and distribution of calcifications （P〉 0.05）. Conclusion： The morphology, concentration,evenness of density, and the number of calcifications showed important significance in the differential diagnosis of benign and malignant breast lesions.