CAJ | 학술논문

目的：探讨钼靶X线在触诊阳性的乳腺病变中的诊断价值。方法分析836例乳腺触诊到结节或肿块（直径0.5～12.6 cm）患者的钼靶X线特点，并以病理学检查结果作为金标准，总结该检查法诊断的准确情况。结果836例患者中病理学检查示增生性病变457例，钼靶X线多表现为棉絮状或结节状致密影，其中硬化性腺病的钼靶X线多表现为肿块形式。炎性病变78例，钼靶X线多表现为斑片状、条索状致密影或腺体局灶性结构扭曲。良性肿瘤129例，钼靶X线多表现为边缘光滑、清楚的类圆形肿块。恶性肿瘤172例，原发性乳腺癌的钼靶X线可表现为不规则肿块、单纯簇状钙化、局限性致密影或腺体局灶性结构扭曲；1例乳腺转移癌表现为皮肤增厚，皮下脂肪层及乳腺腺体脂肪间隙模糊不清。钼靶X线对于增生性病变、炎性病变、良性肿瘤及恶性肿瘤的诊断准确率分别91.9％（420/457）、26.9％（21/78）、91.5％（118/129）、91.3％（157/172）（P＜0.01），钼靶X线检查对于炎性病变的诊断准确率低于其他3种病变（P均＜0.01）。结论钼靶X线对临床触诊阳性的乳腺病变具有较大的诊断价值，对于增生性病变及肿瘤的诊断准确率高于炎性病变。
목적：탐토목파X선재촉진양성적유선병변중적진단개치。방법분석836례유선촉진도결절혹종괴（직경0.5～12.6 cm）환자적목파X선특점，병이병이학검사결과작위금표준，총결해검사법진단적준학정황。결과836례환자중병이학검사시증생성병변457례，목파X선다표현위면서상혹결절상치밀영，기중경화성선병적목파X선다표현위종괴형식。염성병변78례，목파X선다표현위반편상、조색상치밀영혹선체국조성결구뉴곡。량성종류129례，목파X선다표현위변연광활、청초적류원형종괴。악성종류172례，원발성유선암적목파X선가표현위불규칙종괴、단순족상개화、국한성치밀영혹선체국조성결구뉴곡；1례유선전이암표현위피부증후，피하지방층급유선선체지방간극모호불청。목파X선대우증생성병변、염성병변、량성종류급악성종류적진단준학솔분별91.9％（420/457）、26.9％（21/78）、91.5％（118/129）、91.3％（157/172）（P＜0.01），목파X선검사대우염성병변적진단준학솔저우기타3충병변（P균＜0.01）。결론목파X선대림상촉진양성적유선병변구유교대적진단개치，대우증생성병변급종류적진단준학솔고우염성병변。
Objective To discuss the diagnostic value of mammography in the diagnosis of palpable breast lesions. Methods The mammography characteristics of 836 patients with breast nodes or masses (0.5-1 2.6 cm in diameter)by palpation were analyzed. Pathological examination was deemed as the gold standard.The diagnostic accuracy of mammography was evaluated. Results Among 836 patients,457 cases had prolif-erative lesions,characterized as flocculent or nodular dense shadow revealed by mammography. Sclerosing ade-nosis was manifested with masses detected by mammography. Seventy-eight patients had inflammatory lesions, mainly characterized as lamellar and strip dense shadow or topical structural tortuosity of the gland by mammog-raphy. Benign tumors were observed in 1 29 cases,manifested as circular masses with smooth and sharp mar-gin. Malignant tumors were found in 1 72 patients. Patients with primary breast cancer presented with irregular tumors,single clustered calcification,limited dense shadow or topical structural tortuosity of the gland. One case with breast metastasis was characterized as thickened skin and blurry gap between subcutaneous fat layer and breast fat. The accuracy rate of mammography in diagnosis of proliferative and inflammatory lesions,benign and malignant tumors was 91.9% (420/457 ),26.9% (21/78 ),91.5% (1 1 8/1 29 )and 91.3% (1 57/1 72)(P<0.01 ),respectively. The accuracy rate of mammography in diagnosis of inflammatory lesions was significantly lower compared with the other three lesions (all P<0.01 ). Conclusions Mammography is of di-agnostic value for palpable positive breast lesions and the diagnostic accuracy for tumors is higher compared with inflammatory lesions.