乳腺摄影微钙化的LeGal分型与病理的关系

Relationship between Le Gal classification for mammographic microcalcifications with pathology

目的:探讨乳腺摄影时微钙化病灶的Le Gal分型与病理表现的相关性。方法:经病理证实的伴有乳腺微钙化灶的女性患者106例,术前均行数字化乳腺摄影检查,分析微钙化的影像学表现并进行Le Gal分型。结果:本组患者中共发现111个微钙化病灶(5例为双乳病变),经病理证实,恶性病灶50个(45.0%),良性61个(55.0%)。微钙化Le Gal分型中恶性病变的比例分别为:Ⅱ型29.6%(16/54),Ⅲ型31.0%(9/29),Ⅳ型87.0%(20/23),Ⅴ型100%(5/5)。良恶性病灶的微钙化类型的差异有高度统计学意义(P<0.01),且随分型的升高,恶性病变的比例逐渐递增。Ⅱ型和Ⅲ型中,微钙化单位面积数量以及是否合并肿块在良恶性病变间的差异有统计学意义(P<0.05)。结论:乳腺微钙化病灶的Le Gal分型与其病理学表现间有明显相关性,结合其它影像学表现能提高对乳腺良恶性病变的诊断准确性。

Objective.. To evaluate the relationship between Le Gal classification of mammography micro-calcifications （MC） and pathology. Methods.. 106 females with MC showing on digital mammography before surgery and had pathologic diagnosis were recruited. Their mammographic manifestations were analyzed and Le Gal classification was performed. Results..Totally Ⅲ MC lesions were found in 106 cases,including 5 cases with MC in bilateral breasts. There were 50 malignant lesions （45.0%） and 61 benign lesions （55.0 %）. As for Le Gal classification of MC in malignant lesions, there were type Ⅱ （29.6% ,16/54） ,type Ⅲ （31.0% ,9/29） ,type Ⅳ （87.0% ,20/23） and type Ⅴ（100% ,5/5）. The proportion of malignancy was significantly increased related with the upgrading of Le Gal classification, with significant statistic difference （P〈0.01）. Furthermore,in type Ⅱ or Ⅲ ,the ＂number per unit area＂ of MC and existence of accompanied mass lesion showed significant statistic difference in benign/malignant lesions （P〈0.05）. Conclusions.. Le Gal classification is highly related to pathology in breast MC lesions, and the diagnosis accuracy of differentiating benign/malignant lesion can be improved by Le Gal classification of MC in combination with other imaging findings.