全视野数字化乳腺摄影对乳腺微小结节的诊断研究

Diagnosis of full-field digital mammography in minute tubercle

目的分析全视野数字化乳腺摄影对乳腺微小结节的诊断价值，提高术前检m率及诊断率。方法收集兰州军区兰州总医院经病理证实的115例乳腺结节样病变患者临床资料，分析、总结其X线表现特征，并与彩色多普勒超声进行参考对比。结果115例患者中良性65例，钼靶诊断49例，符合率75．0％；超声诊断54例，符合率83．0％；钼靶与超声联合诊断59例，符合率90．0％。恶性50例，钼靶诊断44例，符合率88．0％；超声诊断38例，符合率76．0％；钼靶与超声诊断47例，符合率94．0％。恶性病变钼靶符合率较高，腺病瘤、腺病等良性结节超声诊断符合率更高。二者差异无统计学意义（P〉0．05）。65个良性病灶中纤维腺病24例，纤维腺瘤16例，单纯囊肿12例，导管内乳头状瘤9例，脂肪瘤4例。50例恶性病灶中IDC41例，DCIS3例，Paget’s病1例，恶性分叶状肿瘤1例，浸润性小叶癌2例，黏液腺癌1例，导管内硬癌1例．．二者联合诊断其符合率明显高于单种检查方法。结节伴钙化病例23例，术前钼靶全部诊断正确。结论钼靶x线检查仍为乳腺疾病的主要检查手段之一，联合超声不仅可提高诊断准确率，且可互补，是临床常用的2种检查方法。

Objective To analyze the diagnosis of full-field digital mammography in minute tubercle. Methods Totally 115 specimen of mammary gland tubercle were reviewed. Results Innocuousness were 65 of 115 cases. 49 cases were diagnosed by mammary gland and the coincidence rate was 75.0%. Ultrasonic diagnosis was 54 cases and the correct diagnosis was 83.0% ; 59 cases were diagnosed by uniting manunary gland and ultra- sonic, and the coincidence was 90.0%. 50 cases were malignancy. Mammary gland X-ray was for 44 cases and coincidence rate was 88.0% ; ultrasonic diagnosis was for 38 cases and coincidence was 76.0%. 47 cases were diagnosed by mammary gland X-ray and ultrasonic; coincidence was 94.0%. Diagnosis coincidence of mammary gland x-ray was higher for malignancy but the two groups of evaluation results had no statistical significance（P 〉 0.05）. In 65 benign lesions, fibroadenosis was 24 cases; fibroadenoma was 16 cases; cystis was 12 examples; in- traductal papilloma was 9 cases and liparomphalus was 4 cases. In 50 cases of malignant disease, infitrating ductal carcinoma was 41 cases; ductal carcinoma in situ was 3 cases; paget＇s disease was 1 case; phyllodes tumor of malignant was one ease; infiltrating lobular carcinoma was 2 cases; mucinous adenocarcinoma was 1 case and intraductal seirrhous carcinoma was 1 ease. Nodules with calcification had 23 examples which were correctly diagnosed by mammary gland X-ray. Conclusion Mammary gland X-ray and ultrasound are important for clinical examinations.