晕冕征在乳腺癌诊断中的价值

Value of halo sign in the diagnosis of breast cancer

目的探讨乳腺癌肿块晕冕征的出现与其他相关征象的关系，以及其在乳腺癌X线诊断中的价值。方法收集2011年7月-2012年9月经病理证实、X线表现为肿块型乳腺浸润性导管癌94例，年龄36～82岁，平均年龄53．15岁。所有患者术前均常规照摄双侧乳腺X线内外斜位（MLO）及头尾位（CC）。在肿块周围晕冕征象显示最明显的位置测量其宽度。结果X线表现为圆形或卵圆形肿块21例、分叶状肿块25例、不规则形肿块48例。边缘有毛刺者48例，肿块伴有钙化39例。乳腺癌肿块周围晕冕征的出现率达70．2％，宽度为4～12mm，平均为8．3mm。晕冕征较易出现在退化的脂肪型乳腺，且退化性乳腺中晕冕征多为完整，而非退化性乳腺中晕冕征多为部分，两者之间差异有统计学意义（P=0．000）。在不同大小、形态及伴随征象的肿块中均可出现，其中T1、T2、T3的阳性率分别为79．3％、64．7％和71．4％，差异无统计学意义（P=0．387）；圆形或类圆形肿块为47．6％、分叶状肿块为68．0％、不规则形肿块为81.3％，差异有统计学意义（P=0．018）。边缘有毛刺的肿块，其阳性率达87．5％，明显高于边缘清晰无毛刺征象的52．2％，两者之间差异有统计学意义（P=0．000）。肿块伴钙化与不伴钙化的晕冕征阳性率分别为74．4％和67．3％，两者间差异无统计学意义（P=0．459）。结论晕冕征是肿块周围带状密度减低区域，宽窄不一，可作为辅助征象在肿块良恶性的鉴别中发挥一定作用。

Objective To investigate the value of halo sign in the diagnosis of breast cancer and its correlation with other signs. Methods A total of 94 cases with breast invasive ductal carcinoma which showed mass in full-field digital mam- mography （FFDM） and had been confirmed by surgery and pathology were analyzed from July 2011 to September 2012. The age of patients was from 36 to 82 years old and the average age was 53.15 years old. All the patients were performed routine mediolateral oblique （MLO） view and craniocaudal （CC） view in FFDM. The width of radiolucent halo sign was measured in the most obvious position. Results In FIZDM 21 cases showed round or oval mass, 25 cases showed lobular mass, and 48 cases showed irregular mass. Of all, 48 cases showed spiculated sign, and 39 cases showed mass with calcification. The rate of halo sign in all cases was 70.2% and the width of the sign was 4-12 mm （average 8.3 mm）. The fatty breast was apt to show the complete halo sign and non-fatty breast was apt to show the incomplete halo sign, with significant difference （ P=0.000 ） . The halo sign could appear in masses with different size, shape and other signs. The positive rate of halo sign in T1, T2 and T3 was 79.3%, 64.7% and 71.4%, with no significant difference （P=0.387） . The positive rate of halo sign in round or oval mass, lobular mass and irregular mass was 47.6%, 68.0% and 81.3%, with significant difference （P=0.018） . The positive rate of halo sign in mass with spiculated sign was 87.5% , higher than that of mass without spiculated sign （ 52.2% ） （ P=0.000 ） . The positive rate of halo sign in mass with calcification and mass without calcification was 74.4% and 67.3%, with no significant difference （P=0.459）. Conclusion The halo sign is described as a radiolucent ring surrounding the periphery of a breast mass and it is of some value in differentiating breast tumors.