乳腺导管造影在乳腺导管内疾病诊断中的价值

目的分析乳腺导管造影在乳腺导管内疾病中的影像学表现,比较乳腺导管内疾病在乳腺导管造影与其他影像学检查的影像特点,及乳腺导管造影对导管内疾病诊断的优势,并分析其病理结果,以提高诊断水平。方法对临床表现为乳头溢液并经手术、病理证实的溢液乳腺疾病20例,包括乳腺癌3例、导管内乳头状瘤9例、乳腺导管扩张症6例及2例乳腺囊性增生病,回顾性分析其乳腺导管造影的影像表现及病理特征。结果本组20例:乳腺常规检查诊断导管扩张4例,乳腺囊性增生2例,乳头状瘤0例,乳腺癌1例;乳腺常规检查对乳腺导管内病变检出正确率40%。乳腺导管造影检查诊断导管扩张6例,乳腺囊性增生2例,乳头状瘤9例,乳腺癌2例;乳腺导管造影钼靶摄影对乳腺导管内病变检出正确率为95%。结论乳腺导管造影对溢液性乳腺疾病是一项安全而有效的检查方法,对乳腺导管内占位性病变的定位、定性诊断具有极高价值。对导管扩张症、乳腺囊性增生病等疾病亦能作出较准确的诊断。乳腺导管造影在导管内疾病及早期乳腺癌的诊断中具有不可替代的优势。     

血性乳头溢液的乳腺导管造影诊断

目的 探讨乳腺导管造影在血性溢液性乳腺病中的诊断价值.资料与方法 回顾分析经临床与手术病理证实的25例血性乳头溢液患者乳腺导管造影及钼靶平片的X线表现.结果 导管乳头状瘤1l例,表现为边缘光整的圆形、类圆形充盈缺损;导管内乳头状瘤病2例,表现为末梢导管内多发"斑点"状充盈缺损;导管扩张伴炎症5例,表现为导管扩张、管壁毛糙、模糊;乳腺囊性增生2例,表现为末梢导管呈囊状扩张;乳腺囊肿伴感染1例,表现为对比剂充盈的类圆形高密度影,边缘模糊;导管内癌4例,表现为不规则充盈缺损,导管不规则变形、狭窄、扩张、中断,管壁僵硬.结论 乳腺导管造影能为血性溢液性乳腺病作出明确的病因诊断,为临床治疗方案的制定提供准确的依据.     

乳腺导管造影术及注意事项

目的：通过86例乳腺导管造影，探讨乳腺导管造影的方法及注意事项。方法：采用意大利GIOTTO高频乳腺X线机。对86例有乳头溢液、乳头溢血或乳头后肿块的患者进行乳腺导管造影。结果：86例乳腺导管造影。除3例因导管堵塞严重而致造影失败，其余83例成功进行乳腺导管造影。结论：乳腺导管造影清晰显示乳腺导管内形态、病变位置、性质以及病变范围，是一种极具临床诊断意义的辅助检查。     

乳腺导管造影的X线分析及临床应用

目的探讨乳腺导管造影的X线表现特征及其临床意义。方法本组600例乳头溢液患者行乳腺导管造影,且均经手术病理证实,其中乳头溢液为血性或浆液血性298例(占49.8%),浆液性150例(占25%),清水样106例(占17.7%),其它46例(占7.7%)。结果X线上乳腺导管分为3型:枝叶型354例,占59%;支干型127例,占26.2%;干型87例,占14.8%。主要X线病理表现:导管扩张578例(占96.3%),导管变形561例(占93.5%),导管内充盈缺损349例(占58.2%)及导管破坏39例(占6.5%)。乳腺癌42例(占7%),导管内乳头状瘤312例(占52%),导管扩张症129例(占21.5%),炎症26例(占4.3%),增生症49例(占8.2%),乳腺囊肿25例(占4.2%)以及阴性病例17例(占2.8%)。结论乳腺导管造影有助于乳头溢液的病因诊断。     

乳导管造影在乳腺疾病诊断中的应用及价值

乳导管造影术适用于任何有乳头溢液的患者，特别对乳导管的病变更有其肯定的诊断价值。对于某些乳腺癌的患者，虽无乳头溢液，亦可考虑做乳导管造影检查助诊。2003-2004年间我们对乳头溢液，乳房肿块伴乳头溢液及仅有乳房肿块的110例患者进行了乳腺导管造影检查，现将其检查结果及体会介绍如下。     

数字钼靶摄影乳腺导管造影对伴乳头溢液导管癌的诊断

目的 评价数字钼靶摄影选择性乳腺导管造影对伴乳头溢液导管癌的诊断.方法 回顾性分析11例导管癌伴有乳头溢液的乳腺导管造影检查资料,所有病例均常规进行数字钼靶摄影、患侧乳腺导管造影并经手术后病理证实.结果 乳腺钼靶摄影平片阳性7例,乳腺导管造影阳性11例.造影表现为乳腺导管管壁破坏3例,充盈缺损4例,乳腺导管中断11例、僵硬3例、断续征6例,乳腺导管树的"枯树枝"或"残树枝"状改变2例、潭湖征4例,伴有病变近端乳腺导管扩张3例.结论 乳腺导管造影对诊断伴有溢液的导管癌,尤其对导管内癌或癌前期病变具有定位、定性诊断价值,并且对外科医师确定手术切除范围具有指导意义.     

乳腺导管造影技术在非哺乳期乳头溢液中的应用

目的：探讨乳腺导管造影技术在非哺乳性溢液中的质量控制。方法：对106例非哺乳性溢液的女性患者行乳腺导管造影。并对多乳眼溢液行多次乳腺导管造影检查。结果：106例中93例造影成功，成功率为87．7％。42例为导管占位性病变，阳性率45．2％。结论：乳腺导管造影在非哺乳性溢液患者的检查中是一种简单安全的技术，在乳腺导管系统疾病的诊断和鉴别诊断中起到了重要作用。     

乳腺导管造影诊断溢液性乳腺病34例分析

乳腺导管造影对溢液性乳腺疾病的诊断与鉴别诊断有重要的意义,它能显示病变的部位、大小和范围,确定病变的性质,有助于临床外科手术与治疗.现将我院2001年至2002年乳腺导管造影34例分析如下.     

乳头溢液性疾病的高频超声与乳腺导管声学造影的对比研究

目的:探讨乳腺导管声学造影对乳头溢液性病变的诊断价值。方法:34例乳头溢液患者术前均行高频超声及声学造影检查,所有检查结果均与手术病理结果比较。结果:乳头溢液疾病高频超声及声学造影检查结果与手术病理结果比较诊断符合率分别为61.7%及79.4%,二者比较差异无统计学意义(P>0.05)。导管内乳头状瘤高频超声与声学造影诊断符合率分别为40%及73.3%,二者比较差异有统计学意义(P<0.05)。结论:乳腺导管声学造影可提高导管内小病变的检出率,显示详细的病变部位及扩张的导管,为手术提供重要的参考依据。尤其是导管内乳头状瘤声学造影检查明显优于高频超声检查。此种检查简单、方便、准确性较高,可作为乳头溢液性疾病的首选检查方法。     

乳头溢液导管造影技术的临床应用

乳腺导管造影技术是早期诊断乳腺导管疾病的重要手段。但只有造影成功,才能为诊断医生提供有价值的高质量乳腺导管影像照片,因此应掌握和控制乳腺导管造影技术要点,确保造影成功,从而提高乳腺导管内疾病的检出率。笔者对本院近年来82例乳腺单孔溢液患者进行乳腺导管造影检查的技术要点总结如下。     

50例乳腺导管造影影像质量分析

目的分析影响乳腺导管造影影像质量的相关因素,探讨提高其影像质量的途径。方法对50例乳腺导管造影所获影像按照X线片构成的5大要素：密度、对比度、锐利度、颗粒度及失真度进行评分;将造影成功的48例分为A、B两组,A组按照常规体位（CC位和MLO位）摄片,B组另加摄内外侧位（ML位）,并对比分析。结果50例乳腺导管造影影像质量优良率为92％,摄影体位的优化选择对病变的定位具有明显价值。结论影响乳腺导管造影影像质量的主要因素包括：术前准备、插管技术和摄影技术。掌握乳腺导管造影的规范化操作并全程进行质量控制,可有效提高其影像质量,为临床诊断和治疗提供高质量的影像资料。     

乳腺导管造影技术在乳头溢液性疾病检查中的质量控制

乳腺导管造影作为查找溢液病因的首选检查方法,是一种安全、技术比较简单、诊断率高的方法[1].但目前采用的常规乳腺导管造影方法,尚存在操作难度相对大,分支导管显影不足,对比剂易进入腺泡导致诊断困难等问题.笔者针对造影检查中常遇到的几种因素进行分析,探讨如何改进技术以提高造影的成功率和造影质量.     

The diagnostic value of galactography in patients with nipple discharge

To evaluate preoperative galactographic findings in the differentiation between the benign and malignant lesions in patients presenting spontaneous nipple discharge without mass. Of the 215 patients who have undergone the galactography, 181 cases with abnormal galactography had surgery performed. All galactrograms were reviewed and galactographic findings were correlated to the pathological results to determine diagnostic differentiation. Of the 181 cases we operated on, 112 cases were macroscopically bloody, with 30 cases having cancers (26.8%). Fifty-four cases with serous discharge had seven cancer cases (13.0%). No cancer cases with other color discharge were found. Of the 37 cancer cases, 11 cases had lesions located in the main mammary ducts (lactiferous duct and the segmental duct) (29.7%) and 26 cases had lesions in the peripheral ducts (the subsegmental duct and its branches) (70.3%) (P<.05). Of 113 cases with benign proliferative ductal lesions, 88 cases were located in the main mammary duct (77.9%) and 25 cases in the peripheral mammary duct (22.1%) (P<.05). Otherwise, 29 cancer cases (82.9%) had ductal obstructions and 28 cancer cases (75.7%) had irregular intraductal defects that appeared in the galactograms, which is different from the 113 benign proliferative ductal lesion cases that had 88 cases (71.7%) with ductal dilatation and 90 cases (79.6%) with lobular or smooth intraductal defects (P<.05). These results showed that the cancer cases had a higher rate of locating in the peripheral duct, irregular intraductal duct defects, and ductal obstruction, and a lower rate associated with ductal dilatation or torsion. The galactographic findings were evaluated using the tumor location, types of intraductal defects, ductal obstruction, and dilatation. Preoperative diagnostic galactography is useful in differentiating between the benign or malignant lesions in patients with spontaneous nipple discharge.     

Practical application of local anesthetics

Local anesthetics are widely used in the practice of medicine, particularly within the field of interventional radiology. When used properly, these agents are safe and effective in preventing procedural pain and treating postprocedural pain. The clinician should be aware of proper dosing regimens, techniques, and applications and the methods of preventing and treating complications of systemic toxicity, allergy, and methemoglobinemia. This review provides an introduction to the pharmacology and optimal use of local anesthetics and current strategies for minimizing and managing their potential risks.     

乳腺导管造影的技术要素探讨及质量控制

乳腺溢液是乳腺疾病常见的临床症状,目前常用的检查方法主要有乳腺导管造影、高频彩超、溢液涂片、纤维乳腺导管镜等。我院共行乳腺全数字化摄影6354例,其中有乳腺溢液症状的124例,占总检查人数的1．95％。本文旨在探讨乳腺导管造影技术要素,以提高其诊断准确性及临床应用价值。     

Dynamic bone imaging in the investigation of local bone pathology--when is it useful?

The aim of this work was to establish when, in the investigation of local musculoskeletal symptoms, dynamic isotope bone imaging yields useful information not available from static isotope bone imaging, using 99mTc methylene diphosphonate. One hundred and forty-two dynamic bone scans were reviewed, with particular reference to the site being imaged, the suspected underlying pathology, and the contribution of the dynamic phases to diagnosis, management, and eventual outcome. All were performed as part of the investigation of adult patients complaining of localized musculoskeletal symptoms. The dynamic phases influenced diagnosis, management, and eventual outcome most positively in suspected infection, particularly at a previous fracture site or around a prosthesis. They did not alter management significantly in suspected fracture, avascular necrosis, in most patients with pain of unknown cause, and were rarely helpful in imaging the axial skeleton. We suggest that, in the context of routine bone imaging, dynamic bone scanning should be reserved for cases of suspected infection. In the investigation of most other local bone pathologies, the static phase of the bone scan provides all the diagnostic information which is required for management decisions.     

乳腺导管造影在导管内占位性病变的应用价值

乳腺导管内占位性病变临床上较为常见,它是一组病理性质不同的疾病,常伴有乳头溢液。乳腺导管造影对明确病变部位、性质具有重要价值。本文收集我院2003年3月～2006年5月间经手术病理证实的45例导管内占位性病变乳腺导管造影资料进行总结,旨在提高对导管内占位性病变的术前诊断水平。     

乳腺导管造影在溢液性乳腺癌诊断中的应用

目的：探讨不同病理类型的溢液性乳腺癌在乳腺导管造影中的X线征象,提高对本病的诊断水平。方法：搜集经手术病理证实并行乳腺X线片及腺导管造影检查的乳腺癌108例,溢液性质为血性62例,浆液46例,临床因溢液而疑及乳腺癌。分析不同病理类型乳腺癌（浸润性导管癌64例,浸润性小叶癌23例,其他21例包括髓样癌7例,化生性癌1例,富于脂质癌2例,导管原位癌7例,粘液癌1例,浸润性乳头状癌3例）在乳腺导管造影中的X线征象。结果：乳腺癌导管造影主要征象：鼠尾征13例,导管走行僵直16例,充盈缺损（杯口征）7例,导管扩张99例,截断征（刀切征）24例,导管结构紊乱60例,断续征37例,虫蚀样改变30例,潭湖征32例。108例乳腺癌中有106例合并两种以上征象。浸润性导管癌最多见,64例,占50%;其次为浸润性小叶癌,23例,占21.3%。结论：充分认识溢液性乳腺癌的乳腺导管造影征象,对进一步明确乳腺癌的诊断具有重要价值,合并征象越多,对乳腺癌的诊断价值越高。