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乳腺硬化性腺病的综合影像诊断及临床病理分析 被引量:2

The imaging presentation and clinicopathological analysis of breast sclerosing adenosis
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摘要 目的分析乳腺硬化性腺病(sclerosing adenosis,SA)的X线摄影、超声及磁共振成像(magnetic resonance imaging,MRI)表现,结合临床资料和病理结果,探讨影像检查诊断乳腺SA的价值。方法回顾性分析经病理证实为SA的29例患者(30个病灶)的影像表现和临床资料,并与病理结果进行对照分析。结果30个SA病灶中,5例单纯硬化性腺病,2例伴对侧乳房导管内癌,余伴一种或多种其他良性病变。(1)X线表现:30个病灶的X线图像上表现为肿块(包括肿块合并钙化)、钙化、结构扭曲合并钙化、局灶性不对称,分别占30.0%(9/30)、33.3%(10/30)、6.7%(2/30)及3.3%(1/30),8例未见明显异常。(2)超声表现:28个SA病灶的超声图像上大部分表现为形状不规则(67.9%)、边缘不清晰(67.9%)、不伴血流信号(50.0%)的低回声肿块,其余表现为结构扭曲(14.3%)。(3)MRI表现:9个SA病灶均表现为T1WI低信号、T2WI高信号的肿块,时间-信号曲线Ⅰ型5例、Ⅱ型3例、Ⅲ型1例。另外根据BI-RADS分类,X线摄影、超声诊断SA的误诊率分别为26.7%(8/30)、17.9%(5/28)、11.1%(1/9)。结论SA的影像学表现缺乏其特征性征象,易误诊为乳腺癌等疾病,综合分析术前影像检查,有助于提高SA术前诊断准确率。 Objective To analyze the X-ray,ultrasound,and magnetic resonance imaging(MRI)of breast sclerosing adenosis(SA),and to evaluate the value of preoperative imaging in the diagnosis of SA combined with clinical data and pathology.Methods The imaging and clinical data of 29 cases with SA(30 lesions)who were confirmed by pathology were retrospectively analyzed,then were compared with the pathological results.Results Among 30 lesions,5 cases were simple SA,2 cases with contralateral breast intraductal carcinoma,and the rest with one or more other benign lesions.(1)X-ray manifestations:on the mammogram of 30 SA lesions,the percentage of mass(including mass combined with calcification),calcification,structural distortion combined with calcification,and focal asymmetry were 30.0%(9/30),33.3%(10/30),6.7%(2/30),and 3.3%(1/30)respectively,8 cases without abnormal findings.(2)Ultrasonographic manifestations:on the sonogram,the majority of 28 SA lesions showed hypoechoic mass with irregular shape(67.9%),unclear edge(67.9%),mass without blood flow signal(50.0%),and the rest showed structural distortion(14.3%).(3)MRI manifestations:all 9 lesions showed hypointensity on T1WI and hyperintensity on T2WI.For the time intensity curve,there were 5 cases of typeⅠ,3 cases of typeⅡ,1 case of typeⅢ.In addition,according to BI-RADS classification,the misdiagnosis rates of X-ray,ultrasound,and MRI were 26.7%(8/30),17.9%(5/28),11.1%(1/9)respectively.Conclusions The imaging manifestations of SA are lack of characteristic signs and easy to be misdiagnosed as breast cancer or other diseases,the combination of imaging examination is helpful to improve the accuracy of preoperative diagnosis.
作者 张力莹 赵鑫 李凯凯 殷星 朱超亚 Zhang Liying;Zhao Xin;Li Kaikai;Yin Xing;Zhu Chaoya(Department of Radiology,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Ultrasonic Department,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Pathology,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处 《国际医药卫生导报》 2020年第21期3265-3269,共5页 International Medicine and Health Guidance News
关键词 硬化性腺病 乳腺X线摄影 超声 磁共振成像 病理 Sclerosing adenosis Mammography Ultrasonography Magnetic resonance imaging Pathology
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