不典型乳腺导管原位癌的钼靶X线表现  

Atypical Mammographic Features of Ductal Carcinoma in Situ

作　　者：陈暐[1,2] 许玲辉[1] 彭卫军[1] 芦春花[2] 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科复旦大学上海医学院肿瘤学系,上海200032 [2]南昌大学第二附属医院放射科

出　　处：《实用放射学杂志》2011年第6期890-892,共3页Journal of Practical Radiology

摘　　要：目的分析不典型乳腺导管原位癌（DCIS）的钼靶X线表现，以提高认识。方法回顾性分析经手术病理证实的导管原位癌37例，导管原位癌伴微浸润27例共64例DCIS，观察其钼靶X线表现。结果（1）64例不典型的DCIS中，肿块31例，非对称性致密影14例，乳腺结构扭曲6例，双乳散在良性钙化1例，假阴性12例。（2）31例肿块中，不规则形17例（其中从乳头向深部沿导管走行的长条状肿块3例），椭圆形8例，分叶形5例，星芒状1例。（3）14例非对称性致密影表现者，均为无明显边缘的局限性密度增高影；6例结构扭曲，为正常乳腺结构紊乱但无明显的肿块可见。（4）12例假阴性表现者，11例发生于致密或多量腺体型乳腺，临床有可触及肿块10例，溢液2例。结论不典型导管原位癌的钼靶X线表现多样，以肿块最常见，联合临床体检、B超及MRI能提高其检出。Objective To analyze the atypical mammographic features of ductal carcinoma in situ（DCIS） ,so that to improve the knowledge of DCIS. Methods Mammographic features in 64 consecutive cases with DCIS,including 37 patients with pure DCIS and 27 cases with microinvasion DCIS proved pathology were retrospectively analysed. Results （ 1）There were various features on mammograms of DCIS,including masses （ 31 cases）, asymmetry density （ 14 cases）, focal architectural distortion （ 6 cases ）, calcifications diffused distribution in bilateral breast（ 1 case）and false negative mammograms（ 12 cases）. （2）In 31 cases with masses, the masses in 17 cases were irregular shapes,in which 3 lesions appeared as strip from the deep aspect of the breast to the nipple,8 cases were oval shapes,5 cases were lobular shapes and 1 case had star sign. （3） In 14 cases with asymmetry density, all lesions appeared as focal asymmetric density with ill-defined, of them, focal architectural distortion, which was the normal architecture distortion and no definite masses were visible in 6 cases. （4）In 12 cases with false negative mammograms, the lesions were found in heterogeneous dense or extreme dense breast tissue in 11 cases, 10 cases with palpable masses and 2 cases with discharges were detected clinically. Conclusion The non-calcified mammographic features of DCIS are varied and have some characteristics. But they were easily confused to some other malignant tumor. Mammographic features in combination with clinical and other examinations such as B-ultrasound and MRI are valuable for accurate diagnosis of DCIS.

关 键 词：乳腺 乳腺癌 乳房X线摄影 

分 类 号：R737.9[医药卫生—肿瘤] R814.41[医药卫生—临床医学]