乳腺导管的影像解剖与临床意义  

Clinical value of radiologic anatomy of mammary duct

作　　者：李征毅[1] 石瑾[2] 段刚[2] 梁超[3] 钟光明[1] 徐达传[1] 

机构地区：[1]南方医科大学临床解剖研究所,广东广州510515 [2]南方医科大学南方医院,广东广州510515 [3]深圳市第二人民医院放射科,广东深圳518035

出　　处：《中国现代医学杂志》2010年第7期1055-1058,1062,共5页China Journal of Modern Medicine

摘　　要：目的探讨哺乳期与非哺乳期乳腺导管的影像解剖特征及其临床意义。方法对24例哺乳期妇女进行乳腺超声检查,测量乳腺导管各级分支的内径、数量与分布特征;另对84例107个非哺乳期溢液乳孔行乳腺导管造影检查,分析其形态表现,对导管解剖特征与腺体分型并与导管疾病进行分析比较。结果声像图清晰显示乳腺导管结构,未见明显窦样改变,受压后易变形,左、右侧乳头根部汇集导管平均数目分别为(8.6±2.3)和(9.1±2.6)支,两者之间差异无显著性(P<0.05)。左、右侧乳头根部主导管的平均直径为(2.1±0.6)和(2.2±0.7)mm,两者之间差异无显著性(P<0.05)。导管数量、内径与乳晕大小无明显相关性。非哺乳期乳腺导管显示多支型26支(24.3%)、少支型61支(57.0%)和单支型20支(18.7%)。致密型乳腺8例、斑点型乳腺9例、分叶型乳腺50例和退化型乳腺17例。病理结果显示:导管内乳头状瘤39支(36.4%)、导管扩张症54支(50.5%),其他14支(13.1%)。结论双乳导管的解剖是基本一致的,导管的数目与内径和乳头大小及乳晕范围无明显相关性。少分级型导管主要分布于分叶型腺体中,单支型导管主要分布于退化型腺体中,以乳头状瘤多见。多分级型导管主要分布于致密型腺体中,以导管扩张症多见。了解乳腺导管的影像解剖特征对导管系统疾病的诊断与治疗很有价值。【Objective】To investigate the clinical values of the ultrasound and X-ray anatomic characteristics of the lactating and non lactating mammary ducts.【Methods】The breasts of 24 lactating women were scanned by ultrasound.The diameter,number and distribution of the mammary ducts were measured.One hundred and seven breasts from 84 non lactating women were underwent galactography.The mammary duct patterns and the galactographic features of the anatomy of the breasts were compared with diseases of mammary duct and analyzed.【Results】The structures of mammary ducts were clearly illustrated.The sac-like appearance of lactiferous sinuses was not observed.The mean number of collecting ducts at the base of the nipple was（8.6±2.3） and（9.1±2.6） for the left breast and right breast,respectively,and was not significantly different（P0.05）.The mean diameter of the main ducts at the base of the nipple was（2.1±0.6） mm and（2.2±0.7） mm for the left and right breast,respectively,and was not significantly different（P0.05）.There was no significant correlation between the diameter,the number and the size of the areola of breast.There were 26 branches of multiple fruticoses form（24.3%）,61 branches of less fruti-coses form（57.0%）,20 branches of single fruticoses form（18.7%） in non lactating breasts.Eight cases of thickening mamma,9 cases of mottling mamma,50 cases of lobulated mamma and 17 cases of regressive mamma were shown.The biopsy revealed 39 branches of papilloma（36.4%）,54 branches of mammary duct ectasia（50.5%）,14 branches of rare pathologic types（13.1%）.【Conclusions】The anatomy of left and right mammary ducts is identical.There are no association among the number and diameter of the mammary duct,size of the nipples,and the distribution of the areola of the breast.Less fruticoses form mainly distributes in the lobulated mamma.Single fruticoses form mainly distributes in regressive mamma,and is commonly seen as papilloma.Multiple fruticoses form mainly is shown in thi

关 键 词：超声 乳腺导管造影术 解剖 乳头状瘤 乳管扩张症 

分 类 号：R399.23[医药卫生—基础医学]