乳腺炎、良性增生及乳腺癌FFDM鉴别诊断思路

FFDM differential diagnosis of mastitis,benign hyperplasia and breast cancer

目的探讨乳腺炎、良性增生、乳腺癌的全数字化乳腺X线摄影(Full-field digital mammography,FFDM)鉴别诊断。方法回顾性分析经手术、病理证实的非哺乳期乳腺炎59例、良性增生68例、非肿块型乳腺癌240例,斑片影的观察指标包括其形态、密度、边缘,索条影的观察指标包括索条方向、走行、粗细,通过FFDM征象与病理类型对比进行分组及统计学处理。结果乳腺炎、良性增生、乳腺癌三组之间索条走行、伴钙化、斑片影形态、索条方向、病变分布、斑片影边缘尖角征存在统计学差异(P<0.05)。χ~2分割显示三组之间斑片影形态、索条方向均具有统计学差异(P<0.0125)。结论僵直走行、放射状分布的索条影,形态僵直、段样分布的斑片影,多形性钙化及尖角征对于乳腺癌与其它良性病变的鉴别诊断具有一定价值。

Objective The aim of this study was to investigate FFDM differential diagnosis between breast mastitis,benign hyperplasia and breast cancer.Methods Fifty-nine cases of non-puerperal breast mastitis,sixty-eight cases of benign hyperplasia and two hundred and forty cases with non-mass type breast cancer were analyzed retrospectively,which were verified by surgery and pathology by contrast with FFDM signs,pathological types,grouped and statistics processed.The observation indexes of lamellar shadow included shape,density and edge.The observation indexes of linear shadow included direction,form and diameter.Results The FFDM signs in three groups of breast diseases were statistically significant(P<0.05):the form of linear shadow,accompanied by calcifications,the shape of lamellar shadow,the direction of linear shadow,the distribution of lesion,the sharp angle of shadow edge.χ^2 segmentation show that there were significant differences between three groups(P<0.0125):the shape of lamellar shadow,the direction of linear shadow.Conclusion There have some values for the diagnosis of breast cancer by rigid form and radial distribution of linear shadow,rigid shape and segmental distribution of lamellar shadow,the polymorphic calcifications and the sharp angle sign.