乳腺导管内乳头状瘤的X线诊断

目的：分析乳腺导管内乳头状瘤的X线表现．以提高其诊断准确性。方法：分析32例导管内乳头状瘤的X线平片及导管造影表现．并与病理结果对照。结果：24例X线诊断与病理相符。乳腺钼靶平片：26例无异常发现．6例有异常改变。乳导管造影：14例导管内充盈缺损；10例导管内杯口状堵塞；3例导管扩张；2例管壁不规则狭窄；1例导管分支变细聚拢．远端有一轮廓较清的类圆形块影．2例无异常发现。结论：乳腺导管造影结合平片是诊断导管内乳头状瘤的有效方法，但应注意与导管内癌、导管扩张鉴别。     

伴有乳头溢液乳腺癌与导管内乳头状瘤的乳腺导管造影诊断

目的：总结分析伴有乳头溢液乳腺癌以及导管内乳头状瘤的乳腺导管造影X线表现,评价两者的诊断与鉴别诊断价值。方法：回顾性分析经手术和病理证实的23例乳腺癌和36例乳腺导管内乳头状瘤患者的乳腺导管造影检查影像资料。结果：乳腺癌导管造影主要表现为分支导管内不规则的充盈缺损伴导管壁破坏、导管阻塞中断、“潭湖征”等较为典型的征象;导管内乳头状瘤的导管造影主要表现为大导管内光整的充盈缺损,导管壁多无破坏,并伴有导管扩张以及导管扭曲。乳腺瘤与乳头状瘤在充盈缺损、导管壁破坏、导管完全中断、导管扩张以及“潭湖征”等x线征象上差异有统计学意义（P〈0．05）。乳腺导管造影诊断伴有乳头溢液乳腺癌和乳头状瘤的符合率分别为78．3％和80．1％。结论：不规则的充盈缺损伴导管壁破坏、导管阻塞中断、“潭湖征”等征象及发生部位上乳腺癌和乳腺导管内乳头状瘤两者各有特点,是诊断和鉴别诊断的重点。     

乳腺导管造影在乳腺导管溢液性疾病中的诊断价值

目的：探讨乳腺导管造影在乳腺导管溢液性疾病中的诊断价值。方法：回顾分析了52例乳腺导管溢液性疾病的造影检查资料，病例均经临床检查、钼靶摄片、乳腺导管造影检查及病理证实。结果：肿瘤性病变37例．包括导管内乳头状瘤（单发和多发）30例，导管内乳头状癌2例，浸润性导管5例，其中导管内乳头状瘤最为多见。非肿瘤性病变15例，其中单纯导管扩张症U例，导管扩张伴炎症4例；其中以单纯导管扩张症最为多见。结论：乳腺导管造影对乳腺导管溢液性疾病的诊断与鉴别诊断具有重要的价值。     

乳腺导管乳头状瘤的导管造影表现

目的回顾性分析导管内乳头状瘤的导管造影表现特征,探讨乳腺导管造影检查对导管乳头状瘤的诊断价值。方法40例导管内乳头状瘤患者均行普通钼靶平片及导管造影检查,结合临床资料分析其X线影像表现,并与手术病理结果做对比。结果钼靶平片发现结节1例,1例实性肿块,其余38例正常。行乳腺导管造影后,充盈缺损38例,其中32例为类圆形、杯口样充盈缺损,6例不规则形充盈缺损。38例中,单发肿瘤者32例,多发者6例。2例导管显示正常。28例病灶近端导管扩张。导管造影诊断结果与手术病理结果做比较,准确诊断37例,符合率92.5%(37/40);误诊1例,漏诊2例。结论乳腺导管造影检查对导管内乳头状瘤具有重要的诊断价值,为临床提供了定位、定性的诊断与治疗依据。     

乳管内乳头状瘤临床X线表现与病理对照分析

目的：探讨乳头状瘤Ｘ线平片、导管造影的Ｘ线表现及其与临床、病理的关系。材料与方法：回顾性分析２１例乳管内乳头状瘤的临床特点,乳房Ｘ线平片,导管造影表现及病理改变;并根据病变大小、形态,病变处导管形态及二者的关系,在导管造影片上进行Ｘ线分型且与病理改变进行对比。结果：２１例均有单个乳孔溢液,血性１８例,乳晕区触及肿块３例。乳房Ｘ线平片示乳晕下区肿块４例,左乳晕下区扩张导管１例。导管造影：２１例均示导管内充盈缺损,其中１９例并导管扩张。管内型９例,囊内型９例,实体型３例。Ｘ线表现与病理改变一致。结论：乳管内乳头状瘤最常见的临床表现是单个乳孔溢液,乳腺Ｘ线平片征象少;导管造影特点是管内充盈缺损,对乳头状瘤具有确诊价值。     

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.     

60例乳腺导管内乳头状瘤X线分析

目的：探讨乳腺导管内乳头状瘤的 X 线诊断价值。方法：对60例经病理证实的乳腺导管内乳头状瘤的 X 线资料及临床资料进行回顾性分析。结果：①X 线片45例无明显阳性表现;②12例乳晕及中央区可见大小不同的结节影,其中3例结节内可出现弧形钙化及粗颗粒样钙化,4例可见增粗的导管影,2例既有结节钙化,也伴有导管增粗;③3例中央区仅见增粗的导管影;④X 线乳导管造影检出率在93％以上,其中34例增粗的大导管末端呈杯口状截断,21例可见导管内圆形或卵圆形及柱状充盈缺损,且4例多发,55例导管呈不同程度的增粗。结论：X 线片对乳腺导管内乳头状瘤的诊断有一定意义,但价值有限;乳导管造影对乳腺导管内乳头状瘤的定位定性诊断准确率高,是临床上诊断导管内乳头状瘤较为可靠的影像学检查方法。     

乳腺导管内乳头状瘤的MRI诊断价值

探讨乳腺导管内乳头状瘤的MRI表现及其应用价值。我们回顾性分析经手术和病理证实的21名乳腺导管内乳头状瘤患者的平扫及增强MRI表现。其中14名患者行钼靶X线检查,5例行乳腺导管造影检查。结果发现单发导管内乳头状瘤18例,多发导管内乳头状瘤3例。除外单发型导管内乳头状瘤中的3例的MRI结果显示阴性外,其余病灶在MRI呈两种表现:一种是呈囊状扩张的导管内可见实性肿块,肿块T1WI呈等或稍低信号灶,T2WI呈等或稍高信号灶;增强扫描肿瘤常见均匀强化。另一种的MRI形态学与血流动力学特点多样,部分与恶性肿瘤难以区分。导管内乳头状瘤的MRI表现与某些乳腺恶性肿瘤有类似和重叠之处,但也具有一定特征性;MRI能较准确地发现与定位病灶,对临床诊断与手术治疗具有一定意义。     

乳腺导管系统疾病400例造影分析

目的：为进一步提高乳腺导管系统疾病的Ｘ线诊断水平。方法：作者回顾分析４００例乳腺导管系统疾病的造影资料。结果：肿瘤性疾病占１１％，包括导管内乳头状瘤、导管内乳头状癌、导管癌，其中以导管内乳头状瘤最多见，占６．２５％。非肿瘤性疾病占８９％，包括导管扩张、导管扩张并慢性炎症、浆细胞性乳腺炎、乳腺囊肿、小叶增生、囊性增生，其中以导管扩张最多见，占６２．５％。结论：乳腺导管造影对导管系统疾病的诊断与鉴别诊断很有价值。     

乳腺管造影的诊断价值

作者对乳头有病理性溢液的246名妇女作了306次综合性临床X 线检查,其中包括病史、体检、化验、细胞学检查、X 线摄片、乳腺管造影等。所有这些检查都在经前期进行,以排除内分泌的影响,通过综合性临床X 线检查,诊断为弥漫性纤维囊性乳腺病144例、结节性乳腺病12例、纤维腺瘤29例、囊肿16例、导管内乳头状瘤2例,乳腺癌7例,36例未发现病变。作者共作了283次乳腺管造影,发现乳头有病理性溢液而乳腺管无改变者占14.1%、乳腺管扩张变形占59.1%、导管内囊肿占3.5%、导管内乳头状瘤占11.5%、乳头状瘤病占4.6%、导管内癌占7.2%。     

Solitary breast papilloma: comparison of mammographic, galactographic, and pathologic findings.

OBJECTIVE. Our purpose was to determine the mammographic/galactographic features of solitary breast papillomas and to correlate these features with the pathologic findings. MATERIALS AND METHODS. Retrospective review of pathology files revealed 72 women in whom breast biopsy reports described a solitary papilloma. All patients with additional pathologic abnormalities were excluded from this study. Patients meeting the pathologic criteria and for whom mammograms, galactograms, or both were available and had been obtained within 6 months before biopsy were included. Twenty-four women met these criteria and form the basis of this study. Presenting clinical signs and symptoms were reviewed. Abnormal mammographic/galactographic findings were correlated with pathologic features. RESULTS. Nipple discharge was present in 21 (88%) of 24 patients, two (8%) of 24 patients had abnormal findings on screening mammography, and one patient had a palpable mass that was visible on mammograms. Eight (42%) of 19 mammograms had abnormal findings, including dilated duct(s) in five cases (26%), nodules in two cases (11%), and microcalcifications in one case (5%). All technically adequate galactograms (13/15) had abnormal findings, with 12 (92%) of 13 showing an intraluminal filling defect. The other technically adequate galactogram (8%) showed only a solitary obstructed duct. Ductal dilatation was greatest at or central to the papilloma on 12 (92%) of 13 galactograms. Imaging features correlated well with the histologic findings. CONCLUSION. Patients with solitary papillomas most commonly have nipple discharge, normal mammographic findings, and a galactographic filling defect. Galactography is useful for localizing papillomas.     

乳腺导管内乳头状瘤的X线诊断(附70例报告)

目的　探讨乳腺导管内乳头状瘤的X线特征以提高其诊断水平。方法　回顾性分析经手术病理证实之 70例乳腺导管内乳头状瘤的X线表现。结果　 66例溢液性管内乳头状瘤中 ,2 9例显示圆形充盈缺损 ,7例表现为条状充盈缺损 ,1 7例呈不规则状充盈缺损 ,1 3例出现导管截断 :4例无溢液性管内乳头状瘤均显示结节影。结论　对上述诸多特殊表现的认识 ,在导管内乳头状瘤的正确诊断中具有重要价值     

伴乳头溢液乳腺癌的乳腺导管造影表现与病理对照研究

目的:分析伴有乳头溢液乳腺癌的乳腺导管造影表现,并分析其病理基础,以提高诊断水平。方法:临床表现有乳头溢液并经手术、病理证实的乳腺癌23例,回顾性分析其乳腺导管造影的影像表现,并与手术病理结果进行对比分析。结果:23例中原位癌8例,浸润性导管癌10例(包括单纯癌6例、乳头状癌4例),导管癌早期浸润3例,乳头状瘤病恶变2例。病理上诊断早期癌13例(56.5%),其中8例临床未触及乳腺肿块。乳腺导管造影主要表现:导管内充盈缺损并伴有不同程度的导管扩张12例;乳腺肿瘤侵蚀导管形成潭湖征5例;溢液导管受乳腺肿块推挤,导管变形3例;导管持续显影、管壁不规则伴广泛微钙化灶1例。本组中乳腺导管造影诊断乳腺癌的符合率为82.6%。结论:乳腺导管造影对伴有乳头溢液乳腺癌的检出是一项安全、有效的检查方法,能准确观察到肿块与溢液导管的位置关系、溢液导管受侵蚀程度,而且还能检测出临床触诊阴性的早期乳腺癌。     

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.     

溢液性乳腺疾病导管造影X线征象与病理结果分析

目的:分析溢液性乳腺疾病的乳腺导管造影表现及病理基础,以提高其X线诊断水平。方法:回顾性分析216例溢液性乳腺疾病患者的导管造影及病理资料。结果:共有226支导管造影成功。无明显异常呈阴性表现者占7.5%(17/226);肿瘤性疾病占26.5%(60/226),包括导管内乳头状瘤、导管癌,其中以导管内乳头状瘤多见(22.0%);非肿瘤性疾病占59.7%(135/226),包括导管扩张、炎症及乳腺囊性增生,其中以炎症最多见(39.4%,89/226)。结论: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价值。     

Benign papillary neoplasms of the breast: mammographic findings

The clinical presentation, pathologic characteristics, and mammographic/ductographic (also known as galactographic) findings were reviewed in 77 patients with histologically proved benign papillary neoplasms of the breast. Patients were classified as having either solitary or multiple papillomas. Patients with multiple papillomas were further subclassified as having either central or peripheral papillomas. Fifty-one patients (66%) had solitary papillomas. Thirty-seven of these patients were symptomatic; 36 had spontaneous nipple discharge, and one had a palpable mass. Ductography was positive in 32 of the 35 patients who underwent the procedure. In the 14 asymptomatic patients, subareolar (n = 10) and peripheral (n = 4) mammographic abnormalities prompted biopsy. Fourteen patients (18%) had multiple peripheral papillomas, and one patient also had bilateral central solitary papillomas. Eleven of these patients were asymptomatic, while two presented with palpable abnormalities and one with spontaneous bilateral discharge. Mammographic findings included microcalcifications (n = 5) and clustering nodules (n = 2). Associated atypical ductal hyperplasia was found in six (43%) of the 14 patients with multiple peripheral papillomas. Some of these patients also had lobular carcinoma in situ and radical scars. Twelve patients had multiple central papillomas; all presented with spontaneous nipple discharge and had positive ductograms.     

乳导管内视镜检查309例临床影像资料分析

目的评价乳导管内视镜对乳腺导管内疾患的临床诊断价值。方法回顾性分析309例乳头溢液患者纤维乳导管内视镜检查的临床影像资料。结果309例乳头溢液患者中单侧乳头溢液者290例(93.85%),双乳发生溢液者19例(6.15%)。其中乳导管扩张并炎症208侧(63.41%),闭塞性乳导管炎6侧(1.83%),乳导管积乳并炎症2侧(0.61%),单发导管内乳头状瘤70侧(21.34%),多发导管内乳头状瘤23侧(7.02%),乳导管内癌5侧(1.52%),不能除外乳导管内肿瘤或需随访观察14侧(4.27%)。所有导管内单发或多发乳头状瘤、乳导管内癌病例均经手术与病理证实。结论乳导管纤维内视镜对乳导管内病变的诊断具有重要临床价值,对于导管内可疑乳癌可在导管镜指引下行病灶活检手术。     

乳腺导管内乳头状瘤的X线诊断

目的分析乳腺导管内乳头状瘤的X线特征,以提高其诊断准确性。方法回顾性分析经手术病理证实80例导管内乳头状瘤的X线表现。结果乳导管造影示:24例显示类圆形充盈缺损,12例呈条柱状缺损,30例导管杯口状堵塞,48例导管显著扩张。结论乳腺导管造影是诊断导管内乳头状瘤的有效方法。