不典型乳腺癌全数字化乳腺摄影X线表现规律探讨  

Atypical full-field digital mammographic fmdings of breast cancer

作　　者：刘万花[1] 蒋博[1] 张亚男[1] 蒋燕[1] 金爱萍[1] 魏晓莹[2] 陈炳为[3] 

机构地区：[1]东南大学附属中大医院放射科,南京210009 [2]东南大学附属中大医院病理科,南京210009 [3]东南大学附属中大医院统计学教研室,南京210009

出　　处：《中华放射学杂志》2008年第6期573-576,共4页Chinese Journal of Radiology

基　　金：江苏省科技发展基金资助项目（BK2004001）;江苏省卫生厅重点科研课题基金资助项目（H200543）.

摘　　要：目的探讨不典型乳腺癌全数字化（FFDM）乳腺X线摄影表现规律。方法从2003年4月至2007年7月对门诊及体检者中影像表现不典型的134例乳腺癌或癌前病变进行分析，探讨其FFDM影像表现规律。全部病例采用GE平板2000D全数字化乳腺摄影机检查，体位常规采用头尾位（CC位）、内外斜位（MLO位），必要时加摄侧位及局部点片。对临床未触及包块的乳腺癌均行术前定位。结果（1）影像表现为边界光整的肿块以浸润性导管癌（22／106，20．8％）、黏液腺癌（8／10）及髓样癌（5／6）最多；边界光整的肿块表现随年龄的增加而增多，30～40岁年龄段占其病例总数的13．3％（4／30），81和90岁的2例均为此类型；边界光整的肿块表现随病变局部腺体致密程度减少而增多，依次分别占各自病例总数的14．0％（12／86）、34．5％（10／29）、84．2％（16／19）。（2）粗乱条索影、结构紊乱、结构紊乱伴条索影及伴片状高密度主要见于浸润性导管癌（65例），并主要见于30～40岁（22例）及41～50岁（34例）两个年龄段和病变局部为致密型的腺体组织（55例），其中粗乱条索影最多见于30～40岁，占其病例总数的33．3％（10／30）。（3）全乳房密度增高伴皮下水肿及类肿块影主要见于浸润性导管癌（均为7／8）及41～50岁（5／8）年龄段；全乳房密度增高伴皮下水肿（8例）及未见异常表现（4例）仅见于致密型腺体。结论不典型乳腺癌FFDM影像表现类型与乳腺癌的病理类型、患者的年龄及病变区腺体的致密度有关。Objective To evaluate the diagnostic significance of full-field digital mammography （FFDM） for atypical breast cancer findings. Methods Seven hundred-eighteen cases with breast cancer were examined using FFDM and atypical mammographic findings were found in 134 cases. Craniocaudal （CC） view and mediolateral oblique（MLO） view were conducted for each patient. Mediolateral view or spot view was achieved if necessary. Preoperative localization was conducted for the patients with nonpalpable breast cancers. Results （1） The masses with well-circumscribed margin on mammography were more common in infiltrating ductal carcinoma （22/106） , mucinous carcinoma （8/10）, medullary carcinoma （5/6）, and increased with age and reduction of the mass density. （ 2 ） Long spiculation, architectural distortion, patchy high density were mainly found in infiltrating ductal carcinoma and 30-----40 （24 cases）, 41--50 （34 cases） years old patients. Long speculation was mainly found in 30--40 years old patients （10/30）. （3） High homogenous density and subcutaneous edema in the entire breast and mass-like area were most frequently found in infiltrating ductal carcinoma at 30--40 （2 cases）and 41--50 （5 cases） years old. High density and subcutaneous edema were only found in dense breast （ 8 cases）. Conclusion The atypical findings of breast cancer in full-field digital mammography are associated with the pathological type of cancer, patient age and the gland density of the breast.

关 键 词：乳腺肿瘤 乳房X线摄影术 图像处理 计算机辅助 

分 类 号：R686[医药卫生—骨科学]