乳腺X线检查BI—RADS4级中乳腺浸润性导管癌和纤维腺瘤的鉴别诊断  

The differential diagnosis between infiltrating ductal carcinoma and fibroadenoma coded as BI-RAIDS 4 on mammography

作　　者：邵琳[1] 葛宇曦[1] 陆黎[1] 王子[1] 李晓红[1] 延根[1] 邵婉仪[1] 

机构地区：[1]江南大学附属医院影像科,江苏无锡214062

出　　处：《实用放射学杂志》2016年第9期1371-1373,1397,共4页Journal of Practical Radiology

摘　　要：目的 探讨乳腺X线检查诊断报告中被评估为BI-RADS 4级的乳腺浸润性导管癌（IDC）和纤维腺瘤（FA）的影像学鉴别特征。方法 回顾性分析88例乳腺X线诊断为BI-RADS 4级，经手术、病理证实为乳腺IDC和FA的病例，其中56例为乳腺IDC，32例为FA，观察2种病变的X线征象。结果 56例乳腺IDC平均大小为（2.3±0.89）cm，表现为肿块48例，其中分叶状41例（85.4%），高密度43例（76.8%），边缘浸润26例（54.2%）；表现为结构扭曲8例，均伴有成簇状钙化。32例FA平均大小为（1.8±0.53）cm，圆形或卵圆形24例（75.0%），分叶状7例（21.9%），高密度14例（43.8%），边缘模糊13例（40.6%）。IDC和FA在密度、分叶、边缘浸润和结构扭曲上均有统计学意义（P＜0.05）。结论 通过分析乳腺IDC和FA各自影像学特征，可有效地将两者进行鉴别。Objective To investigate the mammographic features of breast infiltrating ductal carcinoma （IDC） and fibroadenoma （FA） which were coded as BI-RAIDS 4. Methods Retrospective analysis was performed in 88 cases which were coded as BI-RAIDS 4 on mammography and diagnosed as IDC and FA by pathology （56 IDCs and 32 FAs）. Mammographic features were analyzed and compared between IDC and FA. Results The average size of IDCs and FAs were （2.3±0.89） cm and （1.8 ±0.53） cm, respectively. Among 56 cases of IDC, mammography showed as mass in 48 cases, structure distortion in 8 cases with clusters of calcification. Of 48 masses,41 cases （85.4%） were lohulated. 43 cases （76.8%） were high density, and 26 cases （54.2 %） were infihrating margin. Among 32 cases of FA, 24 cases （75.0%1 were round or ovoid, 7 cases （21.9%） were lobulated, 14 cases （43.8%） were high density, and 13 casees （40.6%） were blurred margin. There were significant differences of density, shape, margin between IDC and FA （P〈0.05）. Conclusion IDC and FA coded as BI RAIDS 4, can be effectively distinguished by mammography.

关 键 词：乳腺 浸润性导管癌 纤维腺瘤 乳腺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]