乳导管造影工在乳腺癌诊断中的价值.docVIP

乳导管造影在乳腺癌诊断中的价值 吕凤燕 1白蓉2 史琴英1 甘肃省人民医院 1，乳腺科，2，远程会诊中心 甘肃 兰州 730000 [摘要] 目的： 通过对乳头溢液乳腺病患者导管造影影像学特征分析，来提高对表现为乳头溢液的早期乳腺癌的诊断水平。 方法：回顾性分析经手术病理证实的23例乳头溢液的乳腺癌患者和手术病理证实的23例乳头溢液的导管内乳头状瘤临床资料和乳腺导管造影x线资料，总结早期乳导管内癌导管x线特征，分析误诊、漏诊原因。 结果：23例乳导管内癌中，2例为鼠尾征；4例为截断征；4例导管呈局限性不规则，病变导管僵硬；8例三级导管处造影呈“潭湖样”充盈；3例病变导管跳跃式显示；1例病变导管紊乱，结构不清。而23例导管内乳头壮瘤除有1例导管呈局限性不规则，病变导管僵硬征象外，其余征象均呈阴性。结论：导管造影x线片显示鼠尾征、截断征、潭湖征、导管局限性不规则，导管僵硬和导管跳跃式改变对导管内癌的早期诊断有特征性意义，而病变导管结构紊乱、结构不清提示可疑癌，需定期随访或者联合其他检查手段明确诊断。 [关键词] 乳头溢液,乳腺癌,导管内乳头状瘤，导管造影 Through catheter radiographyto fing mammary gland cacer Lvfengyan,bairong,shiqingying,duxiaoping Ten people’shospital of Gansu ,Lanzhou Gansu 730000,China Abstract:Objective:Through the iconographic analysis of the catheter radiography of the patients suffering from the mammary gland disease of nipple discharge, the diagnostic accuracy of early mammary gland cancers with nipple discharge can be improved. Method: The clinical materials and the X-ray materials of nipple gland catheters of 23 patients of nipple discharge mammary gland cancer and 23 cases of intracanalicular papilloma of nipple discharge proved by operation pathology were analyzed and the X-ray features of early nipple intracanalicular papilloma cancer were concluded. The reasons for misdiagnosis and missed diagnosis were investigated. Results: Of the 23 cases of intracanalicular papilloma cancer, 2 showed rat-tail signs, and 4 cut-off signs. The catheters of 4 cases were irregular and the pathological catheters became still. The radiography at three-class of catheters became full like a lake. The pathological catheters of three cases were displayed saltatorily. The pathological catheter of one case showed disorder and unclear structure. However, of 23 cases of intracanalicular papilloma, except one case showed limited irregularity within catheters and the pathological catheters became stiff, all the other symptoms were negative. Conclusion: The X-ray of breast catheters which display rat-tail