溢液乳腺疾病乳腺导管造影表现与病理(附105例分析)

目的分析溢液乳腺疾病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105例,包括乳腺癌12例、导管内乳头状瘤38例、乳腺导管扩张症43例及12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。结果本组乳腺导管造影正确诊断乳腺癌11例,导管内乳头状瘤35例,乳腺导管扩张症41例,乳腺囊性增生病12例。乳腺癌主要造影表现：导管内充盈缺损,管壁浸润;＂潭湖征＂;导管结构紊乱;管壁不规则伴微钙化灶;乳头状瘤病伴导管壁毛糙破坏,提示恶变。单发导管内乳头状瘤造影表现为大导管内边缘光滑的充盈缺损,导管边缘光整;多发者表现为小分支导管内多发边缘光滑之充盈缺损。乳腺导管扩张症造影表现：大、中、小导管同时不同程度地扩张,或伴有管壁毛糙,分支导管萎缩变形等炎症表现。乳腺囊性增生病中囊肿表现为小导管高度扩张形成囊袋状改变,盲管腺病表现为小导管或末梢导管呈多发小囊袋状改变。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性、定位诊断具有高度价值,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。

Galactography and pathology features of nipple discharge diseases: analysis of 105 cases

Objective To analyze the galactographic features in nipple discharge diseases and to correlate with the pathologic findings,in order to improve the diagnosis accuracy of nipple discharge Diseases. Methods A retrospective study was performed to analyze the galactographic features and pathologic findings in 105 cases of nipple discharge diseases, including 12 cases of breast cancer (10.47%), 38 cases of intraductal papilloma (36.19%), 43 cases of duct dilatation (40.95%), and 12 cases of breast Cystic hyperplasia (11.43%). Results Eleven cases of breast cancer, 35 cases of intraductal papilloma, 41 cases of duct dilatation and 12 cases of breast cystic hyperplasia were diagnosed correctly by galactography. The characteristic imaging features of breast cancer in galactography included duct filling defect,duct invasion, "pool-like" signs, ductal distortion, adnormal duct with numerous micro-calcifications and papillomatosis with duct invasion. The characteristic image feature of solitary intraductal papilloma were sim filling defect in main duct with glabrate borderline,while of multiple intraductal papillomas were numerous small filling defect in branch ducts. The characteristics of duct dilatation covered various degress dilataton in main and all branch ducts, or with ductal distortion and coarse vessel wall. The characteristic image of breast cystic hyperplasia included sacks due to abvious dilatation of small dusts in breast cysts, and numerous small sacks due to dilatation of small dusts and ending dusts in blunt ductal adenosis. Conclusion Galactography praides a safe and highly effective procedure in the diagnosis of nipple discharge dseases.