溢液性乳腺癌的乳腺导管造影表现及病理基础

目的:分析溢液性乳腺癌的乳腺导管造影表现及其病理基础,为临床提供可靠的诊断依据,以提高早期乳腺癌的诊治水平。方法:临床表现为乳头溢液并经手术、病理证实的乳腺癌患者26例,回顾性观察其乳腺导管造影表现,并与病理结果对比分析。结果:26例中,导管原位癌8例;浸润性导管癌5例;导管原位癌伴早期浸润7例;复合型癌3例,其中导管原位癌合并浸润性小叶癌2例,浸润性导管癌合并浸润性小叶癌1例;导管内乳头状瘤病癌变3例,其中乳腺X线平片未发现异常5例,毛刺或分叶状肿块2例,肿块伴钙化9例,多形性钙化灶10例。乳腺导管造影主要表现:导管内充盈缺损伴有不同程度导管扩张;导管管壁浸润破坏对比剂渗漏,形成"潭湖征";导管管壁不规则,呈"虫蚀样"改变或"断续征"。本组乳腺导管造影诊断乳腺癌的符合率为88.4%。结论:乳腺导管造影是溢液性乳腺癌诊断的安全而有效的检查方法,具有很高的定性、定位诊断价值,尤其对临床触诊阴性的早期乳腺癌能作出较准确的诊断,提高了早期乳腺癌的检出率。     

乳腺导管造影对乳头溢液性疾病的诊断价值

目的 探讨乳腺导管造影在溢液性乳腺疾病诊断中的价值.方法 回顾性分析经手术和病理证实的101例溢液性乳腺病的导管造影表现.结果 乳腺导管扩张症23例;乳腺囊性增生症12例;乳腺导管炎8例;导管内乳头状瘤46例;乳腺导管癌9例;乳腺导管结核1例;导管未见异常2例.结论 乳腺导管造影有助于乳头溢液的病因诊断.其在导管良恶性病变的鉴别诊断中有极高的价值.     

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内疾病诊断中的价值

目的分析乳腺导管造影在乳腺导管内疾病中的影像学表现,比较乳腺导管内疾病在乳腺导管造影与其他影像学检查的影像特点,及乳腺导管造影对导管内疾病诊断的优势,并分析其病理结果,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20例,包括乳腺癌3例、导管内乳头状瘤9例、乳腺导管扩张症6例及2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20例:乳腺常规检查诊断导管扩张4例,乳腺囊性增生2例,乳头状瘤0例,乳腺癌1例;乳腺常规检查对乳腺导管内病变检出正确率40%。乳腺导管造影检查诊断导管扩张6例,乳腺囊性增生2例,乳头状瘤9例,乳腺癌2例;乳腺导管造影钼靶摄影对乳腺导管内病变检出正确率为95%。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位、定性诊断具有极高价值。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。乳腺导管造影在导管内疾病及早期乳腺癌的诊断中具有不可替代的优势。     

血性溢液性乳腺疾病的导管造影检查与病理对照分析

目的 :探讨乳腺导管造影在血性溢液性乳腺疾病中的诊断价值。方法 :回顾性分析经临床病理证实的39例乳头血性溢液患者的导管造影X线表现,并与病理结果进行对比分析。结果:本组39例中,造影诊断导管内乳头状瘤27例(69.2%);乳腺癌9例(23.1%);导管扩张囊性增生1例(0.3%);导管炎症导管内分泌物潴留2例(0.5%)。经病理证实,导管造影诊断符合率为89.7%,误诊4例,占10.3%。结论 :乳腺导管造影对血性溢液性乳腺疾病的定性、定位具有较高的诊断价值,尤其对临床触及阴性的导管内乳头状瘤及早期乳腺癌能作出较准确诊断,提高了导管内占位性病变的检出率。     

数字钼靶摄影乳腺导管造影对伴乳头溢液导管癌的诊断

目的 评价数字钼靶摄影选择性乳腺导管造影对伴乳头溢液导管癌的诊断.方法 回顾性分析11例导管癌伴有乳头溢液的乳腺导管造影检查资料,所有病例均常规进行数字钼靶摄影、患侧乳腺导管造影并经手术后病理证实.结果 乳腺钼靶摄影平片阳性7例,乳腺导管造影阳性11例.造影表现为乳腺导管管壁破坏3例,充盈缺损4例,乳腺导管中断11例、僵硬3例、断续征6例,乳腺导管树的"枯树枝"或"残树枝"状改变2例、潭湖征4例,伴有病变近端乳腺导管扩张3例.结论 乳腺导管造影对诊断伴有溢液的导管癌,尤其对导管内癌或癌前期病变具有定位、定性诊断价值,并且对外科医师确定手术切除范围具有指导意义.     

乳腺导管造影在乳头溢液病因诊断中的价值

目的　探讨乳腺导管造影在乳头溢液病因诊断中的价值。方法　回顾性分析 40例乳头溢液乳腺导管造影X线表现 ,并经临床治疗或手术病理证实。结果　正常导管 7例 ,单纯导管扩张 17例 ,导管扩张伴炎症 4例 ,导管扩张伴增生 2例 ,导管内乳头状瘤 8例 ,乳腺导管癌 1例 ,乳腺脓肿 1例。结论　乳腺导管造影术对乳头溢液为主要症状的病因具有较高的诊断价值 ,为临床提供准确的诊断和治疗依据     

乳腺导管造影联合导管内窥镜对溢液性乳腺疾病的诊断价值

目的 :评价乳腺导管造影联合导管内窥镜对溢液性乳腺疾病的诊断价值。方法 :对216例乳头溢液患者同时行乳腺导管造影与导管内窥镜检查,并与病理结果进行对比分析。结果:病理诊断中央性乳头状瘤62例,其中乳腺导管造影正确诊断56例,符合率90.3%,导管内窥镜诊断60例,符合率96.8%;病理诊断外周性乳头状瘤9例,造影诊断7例,符合率77.8%,内窥镜诊断5例,符合率55.6%;病理诊断乳腺癌12例,造影诊断10例,符合率83.3%,内窥镜诊断7例,符合率58.3%。结论:乳腺导管造影联合导管内窥镜可以提高溢液性乳腺疾病的诊断率,减少漏诊率及误诊率。     

乳腺导管造影在溢液性乳腺癌诊断中的应用

目的：探讨不同病理类型的溢液性乳腺癌在乳腺导管造影中的X线征象,提高对本病的诊断水平。方法：搜集经手术病理证实并行乳腺X线片及腺导管造影检查的乳腺癌108例,溢液性质为血性62例,浆液46例,临床因溢液而疑及乳腺癌。分析不同病理类型乳腺癌（浸润性导管癌64例,浸润性小叶癌23例,其他21例包括髓样癌7例,化生性癌1例,富于脂质癌2例,导管原位癌7例,粘液癌1例,浸润性乳头状癌3例）在乳腺导管造影中的X线征象。结果：乳腺癌导管造影主要征象：鼠尾征13例,导管走行僵直16例,充盈缺损（杯口征）7例,导管扩张99例,截断征（刀切征）24例,导管结构紊乱60例,断续征37例,虫蚀样改变30例,潭湖征32例。108例乳腺癌中有106例合并两种以上征象。浸润性导管癌最多见,64例,占50%;其次为浸润性小叶癌,23例,占21.3%。结论：充分认识溢液性乳腺癌的乳腺导管造影征象,对进一步明确乳腺癌的诊断具有重要价值,合并征象越多,对乳腺癌的诊断价值越高。     

乳腺导管造影在溢液乳腺疾病诊断中的应用价值(附70例报告)

目的探讨乳腺导管造影在溢液乳腺疾病诊断中的应用价值。方法回顾性分析70例经手术及病理确诊的乳头溢液乳腺病的X线特点,结合临床及病理特征进行鉴别诊断。结果导管内乳头状瘤45例,导管癌5例,导管扩张症17例,导管增生伴炎症3例。结论乳腺导管造影在导管肿瘤良恶性的鉴别及导管炎性疾病的诊断中有极高的应用价值,可为临床提供准确的诊断和治疗依据。     

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.     

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。     

乳腺导管造影对乳腺溢液性疾病诊断的临床价值

目的:探讨乳腺导管造影对溢液性乳腺疾病的诊断价值,提高其X线诊断与鉴别诊断水平。方法:回顾性分析39例乳头溢液患者的临床、影像及病理资料。结果:39例患者46个病灶乳头溢液患者中纤维腺瘤5个,乳腺癌6个,导管内乳头状瘤12个,纤维囊性乳腺病及小叶增生5个,误诊1例,乳腺癌诊断准确率为85.7%。结论:乳腺导管造影术是诊断溢液性乳腺疾病的有效方法,对其诊断与鉴别诊断有很重要的价值,可为临床提供可靠的诊断治疗依据。     

乳腺单发乳头状瘤钼靶X线诊断（附42例报告）

目的：提高对乳腺单发乳头状瘤放射学诊断水平。材料与方法：作者回顾分析了４２例经病理证实的乳腺导管内单发乳头状瘤临床表现，钼靶平片及造影片表现。结果：３７例（８８％）有乳头分泌物。９５％（３５／３７）发生于中央大导管。２４％（１０／４２）平片有异常改变。造影表现：５４％（２０／３７）表现导管内充盈缺损，４１％（１５／３７）表现导管完全阻塞，４３％（１６／３７）有导管轻度扩张。结论：乳头溢液为导管内乳     

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.