【作者】 孙江宏； 高桂芬； 张修石； 张丽莎； 姜丹；

【Author】 Sun Jiang-Hong Gao Gui-Fen Zhang Xiu-Shi Zhang Li-Sha Jiang Dan Department of Radiology ,The Tumor Hospital of Haerbin Medical University ,Haerbin,150040,China

【机构】 哈尔滨医科大学附属肿瘤医院；

【摘要】 目的:探讨直接数字化乳腺X线摄影对微小癌的诊断价值,重点分析其X线征象特征。方法:回顾性分析经手术、经病理证实的微小乳腺癌68例。所用仪器为直接数字化乳腺X机,采用后处理工作站屏幕阅读方式,不可触及的病灶(占38%)行术前金属丝标记定位。结果:本组15例(占 22％)属原位癌,浸润性癌中73％为导管癌。直接数字化X 线征象表现为结节39例(57％),单纯钙化14例,结构紊乱 8例,致密影7例,其中除单纯钙化外,其它征象伴有钙化者 4l例。结论:直接数字化乳腺X线摄影图像质量高,屏幕阅读方式对微小癌的检出和诊断提供了技术支持,长径≤15mm 的微小病灶,具备以下征象时,对诊断乳腺癌有参考意义:(1) 结节呈分叶状、高密度、边缘毛刺;边缘毛糙,类似“绒球”状,形状规则或仅见浅分叶,但伴有细钙化;(2)单纯钙化密集层叠分布、形态明显不一、以低密度的细钙化为主,(3) 局限性结构紊乱,边缘乳腺小梁明显僵直,“彗星尾”征多见, 尤其是伴有细钙化者;(4)不对称性局限性致密影,密度进行性增高,或伴细钙化。更多还原

【Abstract】 Objective: To investigate the evaluation of direct digital mammography in the diagnosis of minute breast cancer,and analysis especially imaging features. Methods: The mammographic findings of 68 cases with pathologically proved minute breast cancer were retrospectively analyzed.The X-ray diagnosis were done by screen reading of workstation. Wire-localization was performed on nonpalpable lesions (38%).Both were verified by pathology. Results: 15 cases (22%)were ductal carcinoma in situ, 73% of infiltrating carcinoma were ductal carcinoma.Nodes were found on direct digital mammo-gram in 39cases(57%), Isolated microcalcifications were found in 14 cases, architectural distortion were found in 8 case and of 2 cases with asymmetrical increase of local density on mammogram. Microcalcifications were found in 14 cases except isolated microcalcifications. Conclusion: Direct digital mammography have superior imaging,more minute breast cancer may found by screening reading mode. Some imaging features are very helpful for the diagnosis of minute cancer ( ≤ 15mm), as follows: (1)Multi-lobular nodes with spicular and high density ,like knitting wool ball when nodes have short and thin spicular,regular nodes with microcalcifications,(2)Isolated clustered microcalcifictions have different shape,majority calcifictions are microcalcifictions with lower density, (3) Local architectural distortion with straight marginal tra-beculae, sigh of comet tail or microcalcifications, (4) Asymmetry local dense area with increasing density or microcalcifications.更多还原