数字化乳腺摄影误漏诊病例分析

An analysis of misdiagnostic breast cases with digital mammography

目的分析乳腺x线检查误漏诊病例的影像表现，以提高乳腺疾病的诊断水平。方法回顾性分析2009—2012年误漏诊病例14例，均进行X线检查，经术后病理证实，分析误漏诊原因。结果颗粒细胞瘤2例误诊乳腺癌，哺乳期乳腺癌误诊乳腺炎症1例，黏液腺癌误诊为乳腺腺纤维瘤2例，多中心乳腺癌误诊单病灶1例，脂肪坏死误诊为乳腺癌3例，放射状瘢痕2例误诊为乳腺癌，1例淋巴瘤误诊为乳腺癌，2例腺纤维瘤漏诊。结论乳腺x线检查有一定的限度，局部点压放大摄影能更好地显示病变的细节，乳腺良恶性病变在临床表现及x线征象上均有重叠性，结合临床及多种检查方法联合诊断有助于提高乳腺疾病的诊断准确率。

Objective To analyze the imaging manifestation of misdiagnostic breast cases with digital mammography in order to improve the diagnostic level of breast diseases. Methods Fourteen misdiagnostic breast cases from 2009 -2012 with digital mammography and surgico- pathologic approval were summarized to investigate the causes. Results All of 14 misdiagnos- tic cases were revealed the exact etiology as follows： 2 cases of granular cell tumor misdiag- nosed as breast cancers, 1 case of breast cancer misdiagnosed as breast inflammation during lacto-feeding stage, 2 cases of mucinous adenocarcinoma misdiagnosed as breast adenofibroma, 1 case of muhicentric breast cancer misdiagnosed as single lesion case, 3 cases of fat necrosis misdiagnosed as breast cancers, 2 cases of radial scar misdiagnosed as breast cancers, 1 case of lymphoma misdiagnosed as breast cancer, and 2 cases of adenofibroma were losed in diagnosis. Conclusion There are certain limitations for digital mammography, therefore, localized spot compression magnification technique is needed for further revealing of lesions in detail, the combination of clinical features and imaging manifestation is crucial for elevation of the diagnos- tic accuracy on account of the overlapping clinical symptoms and mammographic signs of benign and malignant breast diseases.