成簇细小钙化在乳腺疾病X线诊断中的分析

The Analysis of Clustered Minute Calcifications in Rediological Diagnosis of Mastopathy

目的 :探讨成簇细小钙化在乳腺疾病X线诊断中的意义 ,分析其对乳腺癌诊断的特异性价值。方法 :复读 4 5例乳腺疾病的X线钼靶摄片 ,复查并分析其临床病案资料和病理资料。结果 :4 5例中乳腺癌 39例占 86.7% ,乳腺良性病变 6例占 13.3% ,临床上触及肿块而乳腺钼靶摄片中见明显成形影块 ,边缘呈毛刺改变 ,块影内或外见成簇细小钙化 2 9例 ,均经手术活检证实为乳腺癌。发现 8例临床未及乳腺肿块因X线摄片见成簇细小钙化 ,占 17.6% ,其中 4例病理证实为导管内癌。钙化的形态、数量、分布与肿块大小、分期及腋下淋巴结转移无关 ,并以泥沙样局限于肿块内钙化多见 ,病理中也能看到2 4例有钙化。结论 :成簇细小钙化在乳腺疾病的X线诊断中有重要意义 ,对于临床触及乳腺肿块而摄片中见成簇细小钙化存在于有毛刺、呈分叶状边缘的块影或结节 ,诊断一般不存在困难 ,往往提示恶性。而摄片见成簇细小钙化临床又未触及乳腺肿块一定不能掉以轻心 ,虽然存在良性乳腺疾病可能 ,仍应在放射科和病理科配合下行手术活检以明确钙化性质。

s Objective To discuss the significance of clustered minute calcifications in the X ray diagnosis of mastopathy,and to analyse and assess its specific value to breast cancer.Methods To re interpret 45 Mo target X ray films of mastopathy,and to review and analyse the relevant clinical records and pathological data.Results of the 45 cases,39(86.7%)were breast cancer and 6(13.3%)were benign mastosis. In 29 cases,masses could be seen clearly in the Mo target films,the edges showing burlike changes while clustered minute calcifications being found within or around the shadow,All the 29 cases were confirmed to be breast cancer by surgery or biopsy.Eight cases(17.6%) were found with clustered minute calcifications in the X ray films,though clinically masses were not palpable; intraductal carcinoma was confirmed by pathology in 4 of them.The morphology,quantity and distribution of calcifications were not correlated with the sign of mass,staging of disease and axillary lymph node metastasis.In most of the cases,the calcifications were sand like and limited within the mass,while pathologically 24 cases of calcifications were found.Conclusions Clustered minute calcification is of great importance in the X ray diagnosis of mastspathy.In those with palpable masses and X ray presentation of clustered minute celcifications existing in the shadow or node with burlike and lobulated edge,the diagnosis is not difficult as malignancy is often suggested.The presence of clustered minute calcifications in radiology without clinically papable masses should not be taken lightly,in spite of the possibillity of benignancy.Biopsy with the cooperation of the radiology and pathology departments should be performed to clarify the nature of calcifications.