乳腺腺病X线特点分析及鉴别诊断  

The mammography characteristic analysis and differential diagnosis of the adenosis of breast

作　　者：徐维敏[1] 陈卫国[1] 廖昕[1] 文婵娟[1] 唐浩[1] 叶华秀[1] 

机构地区：[1]南方医科大学南方医院放射科,广东广州510515

出　　处：《医学影像学杂志》2015年第9期1596-1599,1603,共5页Journal of Medical Imaging

摘　　要：目的分析乳腺腺病主要X线表现、X线表现异同及鉴别诊断,以提高对其X线特点认识。方法回顾性分析我院2010年1月至2013年12月行X线检查并经病理证实乳腺腺病177例(共182侧)。结果 177例(共182侧)中包括69侧腺病、50侧腺病伴纤维腺瘤形成趋势、36侧腺病伴不同类型导管上皮增生、27侧腺病伴钙化。主要X线表现为:1不同病理结果腺病多表现为肿块81侧(44.50%)、钙化45侧(24.72%);2硬化性腺病组多表现为肿块37侧(57.81%)、不对称致密影12侧(18.75%),而非硬化性腺病组多表现为肿块44侧(37.29%)、钙化35侧(29.66%);3表现为单纯钙化的腺病共46侧(25.27%),钙化主要X线特点为:细点状钙化(36.95%)、成簇或区域分布(各41.30%)、细点钙化成簇分布(19.59%);4腺病伴纤维腺瘤形成趋势多表现为肿块33侧(66.00%),不对称致密影9侧(18.00%)。结论本组乳腺腺病主要X线表现为肿块及钙化,且不同病理结果之间的X线表现不具有特征性,仅依据X线表现难以鉴别。但表现为单纯钙化时,其钙化具有一定的特征性,可与恶性病变进行鉴别,同时也可根据钙化特点鉴别硬化性与非硬化性腺病。腺病伴纤维腺瘤形成趋势与纤维腺瘤伴腺病形成趋势的主要X线表现类似,鉴别诊断存在较大的难度,主要依靠病理诊断。Objective To explore the main mammograhic appearance of the adenosis of breast, and the similarities and differences between different pathological results of the adenosis of breast. Methods 177 cases （atotal of 182 laterals） of the adenosis of breast by the pathology were retrospectively analyzed. Results All cases included adenosis （69 laterals）, adenosis with fibroadenoma forming tendency （50 laterals）, adenosis with types of ductal hyperplasia （36 laterals）, adeno- sis with calcification （27 laterals）. The main mammograhic features： ① The main appearance of the different patho-result were mass in 81 laterals （44.50%） and calcification in 45 laterals （24.72%）; ② The main appearance of the sclerosing adenosis was mass （57.81%） and asymmetric density （18.75 % ）; while the non-sclerosing adenosis was mass （37.29 % ） and calcification （29.66%） ; ③46 laterals of all cases （25.27%） were found as simple calcification, and the main appear- ance of the calcification was punctate （36.95 % ）, clustering or regional （41.30 % each）, and clustering punctate calcifica- tions （19.59 %）;④The main appearance of the adenosis with fibroadenoma forming tendency was mass （66.00 %） and asymmetric density （18.00%）. Conclusion The main mammograhie feature of all is mass and calcification, it is hard to discriminate different types of the adenosis preoperative by mammograpy. While the adenosis was found as simple calcifica- tion, there is specific feature of the calcification. And the feature of the calcification is different between the adenosis and the breast malignant disease, the selerosing adenosis and the non-sclerosing adenosis also. It is hard to discriminate the ad- enosis with fibroadenoma forming tendency and the fibroadenoma with adenosis forming tendency only by mammography, as the main feature of them is similar extremely.

关 键 词：乳腺 腺病 X线诊断 

分 类 号：R814[医药卫生—影像医学与核医学] R737.9[医药卫生—放射医学]