乳腺脂肪坏死的X线和超声诊断

目的探讨乳腺脂肪坏死的X线及B超表现，提高对本病影像诊断的认识。资料与方法回顾性分析25例经手术、病理证实的乳腺脂肪坏死X线平片及超声声像图表现。结果X线片表现：(1)双侧乳腺结构、密度不对称10例；(2)淡薄片影3例；(3)有毛刺的结节5例；(4)X线片无阳性发现5例。超声声像图表现：(1)16例(16／17，94．1％)非医源性脂肪坏死病灶位于皮下脂肪层；(2)结节回声高低不一(高、低、无)；(3)彩色Doppler超声病灶无血流信号8例。结论乳腺脂肪坏死根据其病因和时期，其影像表现多种多样。X线与B超检查结合，本组有65％可排除乳腺癌的诊断。位于乳腺脂肪层内的网状片影或有毛刺的结节首先考虑脂肪坏死的可能，紧密结合临床病史，可提高本病诊断准确性。

Mammographic and Sonographic Manifestations of Fat Necrosis of the Breast

Objective To evaluate mammographic and sonographic findings of fat necrosis of the breast and to improve the imaging diagnosis of the disease. Materials and Methods Radiographic and sonographic findings in 25 cases with pathologically proved breast fat necrosis were retrospectively analyzed.Results The radiographic manifestations included: (1) asymmetrical architecture and density of the left and right breast (n=10); (2) focal faint opacities (n=3); (3) nodules with spicules (n=5); (4) no abnormal radiographic findings (n=5). The sonographic findings were as follows: (1) non iatrogenic fat necrosis in subcutaneous fat layer (n=16/17, 94.1%); (2) the nodule being hyper echo, hypo echo, or echoless; (3) the lesion showing no flow signal on color Doppler sonographs (n=8). Conclusion The imaging manifestations of fat necrosis of the breast varies with its etiology and stage. Combined with sonography and clinical information, mammography can exclude malignancy in 65% cases in this study. For a faint reticular opacity or a spiculated nodule in subcutaneous fat layer, fat necrosis should be the first consideration.