157例乳腺浸润性导管癌全数字化X线征象分析  

The analyses of X-ray signs of 157 cases of breast infiltrating ductal carcinoma with full-field digital mammography

作　　者：陈玉兰[1] 董江宁[1] 王婷婷[1] 吴瑶媛[1] 

机构地区：[1]安徽省肿瘤医院安徽省立医院西区医学影像科,安徽合肥230031

出　　处：《医学影像学杂志》2016年第4期641-644,共4页Journal of Medical Imaging

基　　金：安徽省科技攻关项目卫生专项基金(1301043024)

摘　　要：目的探讨乳腺浸润性导管癌(IDC)全数字化X线征象,提高诊断准确率。方法收集术前行数字化乳腺X线摄影检查且术后经病理证实为乳腺浸润性导管癌患者157例,回顾性分析IDC全数字化X线表现特征。每位患者摄取乳腺头尾位和内外侧斜位(CC位和MLO位),部分加拍切线位、扩大头尾位、乳沟位、90°侧位及点片压迫位。5例加做乳腺MRI。结果 157例IDC的直接征象中,乳腺肿块伴头皮屑状、不定形或蠕虫状微钙化90例(57%);单纯肿块44例(28%);结构扭曲或局部密度增高18例(11%),其中4例伴微钙化;单纯微钙化5例(3%)。本组157例IDC显示间接征象有154例,占98%。IDC有以下间接征象:血管增粗、增多(52/157),导管增粗(45/157),乳晕及皮肤增厚(41/157),乳头凹陷(39/157),乳内或腋前区淋巴结肿大(70/157)。结论乳腺分叶或/和毛刺状肿块及头皮屑状、不定形、蠕虫样、分支杆样微钙化是乳腺IDC的主要X线征象;对于X线主要征象不典型者,需在专业工作站仔细观察间接征象综合分析,可以有效提高术前IDC诊断准确率。Objective To analyze the signs of full-field digital mammography（ FFDM） in breast infiltrating ductal carcinoma（ IDC） and to raise the diagnostic accuracy. Methods For 157 cases with surgically and pathologically proved breast infiltrating ductal carcinoma,IDC signs of full-field digital mammography were analyzed retrospectively. Craniocandal（ CC） view and mediolateral oblique（ MLO） view were conducted for each patient. Besides,tangential view,exaggerated craniocaudal view,cleavage view,90° lateral view or spot compression view were examined if necessary. 5 cases were facilitated with breast MRI. Results157 cases of direct signs of IDC included mass with dandruff,amorphous,or vermicular microcalcification in 90 cases（ 57%）,mass only in 44 cases（ 28%）,architecture distortion or focal asymmetric density in 18 cases（ 11%）,4 cases with microcalcification,microcalcification only in 5 cases（ 3%）. 154 cases of IDC with indirect signs（ 154 /157,98%） inclued blood circulation increased（ 52 /157）,enlargement of the catheter（ 45 /157）,areola and skin thickening（ 41 /157）,nipple retraction（ 39 /157）,breast or axillary lymph nodes enlargement（ 70 /157）. Conclusion Lobulated and / or burr shape breast mass,dandruff form,amorphous,vermicular and branch microcalcification are the main signs of IDC. For untypical X-ray signs of IDC,careful observation of indirect signs in professional workstation is needed to integrate analysis,IDC preoperative diagnostic accuracy can be effectively improved.

关 键 词：乳腺 浸润性导管癌 全数字化X线 直接征象 间接征象 

分 类 号：R737.9[医药卫生—肿瘤] R814[医药卫生—临床医学]