乳腺等密度肿块的乳腺 X 线摄影评价  

Evaluation of breast isodense masses using mammography

作　　者：孔俊沣[1] 周子和[1] 牟方胜[1] 朱世培[1] 罗勇[1] 李杰[1] 

机构地区：[1]重庆三峡中心医院放射科,重庆404000

出　　处：《实用放射学杂志》2015年第6期933-937,共5页Journal of Practical Radiology

摘　　要：目的：探讨乳腺 X 线摄影中,乳腺恶性等密度肿块的特征性表现。方法收集经手术病理证实的121个乳腺等密度肿块,分别对肿块大小、形态、边缘、肿块周围结构改变、腋窝淋巴结改变、皮肤改变、乳头改变、可疑恶性钙化灶等观察指标与病理结果对照。运用χ2检验和 Logistic 回归分析,评价各指标对恶性等密度肿块的诊断价值。结果121个乳腺等密度肿块中,良性肿块73个、恶性肿块48个。经χ2检验单因素分析,影响肿块性质的因素有：肿块形态（χ2=14.376,P =0.002）、肿块边缘（χ2=21.555,P =0.000）、肿块周围结构紊乱扭曲（χ2=26.939,P =0.000）、腋窝淋巴结肿大（χ2=16.285,P =0.000）、皮肤增厚（χ2=4.698,P =0.030）。经多变量二分类 Logistic 回归分析,筛选进入 Logistic 回归模型的危险因素有：肿块边缘浸润（P =0.014）、肿块周围结构紊乱扭曲（P =0.003）、腋窝淋巴结肿大（P =0.026）。结论边缘浸润、周围结构紊乱扭曲、腋窝淋巴结肿大为乳腺恶性等密度肿块的特征性表现,在鉴别诊断中具有极其重要的价值。Objective To explore the characteristic manifestations of breast malignant isodense masses using mammography. Methods 121 breast isodense masses with pathological confirmations were collected.Compared indicators with pathological findings were the tumor size,shape,edge,structure changes around the mass,axillary lymph nodes,skin changes,nipple changes,suspi-cious malignant calcification.χ2 test and Logistic regression analysis were used to evaluate the diagnostic values of each indicator.Re-sults In the 121 isodense masses,73 were benign,48 were malignant tumors.According to χ2 test analysis,factors impacted the nature of mass including：tumor morphology （χ2 =14.376,P =0.002）,tumor edge （χ2 = 21.555,P =0.000）,structure twisted surrounding the mass （χ2 =26.939,P =0.000）,axillary lymph nodes （χ2 =1 6.285,P =0.000）,skin thickening （χ2 =4.698,P =0.030）.According to multivariate binary Logistic regression analysis,risk factors of the Logistic regression model included：edge infiltrating of mass （P =0.014）,structure twisted surrounding the mass （P =0.003）,axillary lymph nodes （P =0.026）.Conclusion The characteristic manifestations of breast malignant isodense masses include edge infiltrating,structure twisted surrounding the mass,axillary lymph nodes.These manifestations are of great significance in differential diagnosis of breast isodense masses.

关 键 词：乳房 X线摄影术 乳腺肿块 等密度 LOGISTIC 回归 

分 类 号：R655.8[医药卫生—外科学] R814.41[医药卫生—临床医学]