乳腺不典型孤立小结节性病变的X 线定性诊断分析

目的：探讨<2 cm 的乳腺不典型孤立结节性病灶 X 线定性诊断要点。方法回顾性分析52例不典型小结节病灶的诊断及 X 线与临床特点。结果52例结节性病灶中,良性结节23例,恶性结节29例。其中被误诊为良性病变26例,X 线特点：结节形态规则,密度较均匀,边缘大部分光滑,可无分叶。被误诊为恶性病变19例,X 线特点：结节形态不规则,密度不均匀或伴多钙化灶,边缘或略分叶、毛糙、毛剌、周围结构不规则,或局部皮肤增厚,皮下脂肪浑浊。不能及时诊断7例,X 线特点：形态规则、不甚规则,密度不均匀、欠均匀,或周围结构欠规则,缺乏典型特征性表现。结论掌握各病变的病理 X 线特点及不典型表现,全面细致分析,结合超声及临床触诊,必要时 MRI、活检及随访多能作出正确诊断。

Mammography qualifying diagnosis analysis of atypical solitary breast nodules

Objective To investigate the qualitative diagnostic features of less than 2 cm atypical solitary breast nodules.Methods 52 patients diagnosed with atypical solitary breast nodules as well as the mammography and clinical characteristics were analyzed retrospectively.Results Among those 52 cases of nodular lesions,there were 23 benign nodules and 29 malignant nodules.Among these 29 malignant cases,26 cases were misdiagnosed as benign lesions,the X-ray of which showed the margin of nodules were mostly smooth,the density relatively homogenic yet with no sign of lobulation.Meanwhile,19 cases were diagnosed as malignant lesions, the X-ray of which showed irregular nodules,uneven density with or without multiple calcification,their margin lobulated,ragged, and ambient structure irregularity.In some case their local skin thickened and subcutaneous axungia were turbid.There were 7 cases unable to make timely diagnosis,the X-ray of which showed more or less regular form,uneven or almost even density,ambient structure barely regular,lack typical features.Conclusion To make accurate diagnosis,it is necessary to understand the characteristics of the pathology X-ray of different lesions,the atypical manifestation,plus comprehensive and detailed analysis,combing ultrasound and clinical palpation,MRI,biopsy and follow-ups when needed.