论著-头颈部
5例乳腺放射状瘢痕患者的影像学表现
作者:曾茹雪1 黄 文1 刘 倩2 唐继芳1 钏冬媚1 刘 婷1
所属单位:1.四川省德阳市人民医院放射科 2.四川省德阳市人民医院病理科(四川 德阳 618000
PDF摘要
目的 研究乳腺放射状瘢痕患者 的影像学表现,以减少乳腺放射状瘢痕的 误诊率和及早发现乳腺放射状瘢痕患者。 方法 采用病理活检和免疫组化方法来确 诊5例乳腺放射状瘢痕患者,并分析乳腺 放射状瘢痕的病理学表现,以研究其X线 和MRI影像学表现。结果 乳腺放射状瘢痕 病灶呈放射状,弹力纤维变性,乳腺导管 小而不规则,伴有不同程度的增生。免疫 组化表明calponin分布细胞膜,腺体周围 有腺上皮细胞。5例乳腺放射状瘢痕患者X 线显示,癌灶周围可有钙化灶或小结节, 结节周围有毛刺影。MRI中,呈类圆形结 节,边缘模糊,呈等T1长T2信号,增强扫 描结节呈不均匀强化。结论 乳腺放射状 瘢痕缺乏特异性影像学表现,但结合多种 影像学改变有助于早期发现病灶。
Objective This study was to research the image manifestations of 5 patients with radial scars, it was in order to reduce the misdiagnosis rate of radial scars and discover the patients early. Methods The 5 patients with mammary gland radial scar were identified by the the pathological biopsy and immunohistochemistry (IHC), analyzing the pathological manifestation of mammary gland radial scar. This was to study the X-ray and MRI imaging manifestations. Results The radial scar breast lesions was radiated, the elastic fiber was degeneration, the ductal was small and irregular, following varying degrees of cattle. The IHC assay showed that calponin was located cell membrane, gland epithelial cells was appeared. The X-ray of 5 cases showed that the nodules with calcification was near the neoplastci, it was surrounded by burr. In the MRI, the neoplastici foci was circular nodules, a T1 long T2 signals, their edge was blur. The enhancement scanning showed the nodules are improved. Conclusion The radial scar was lack of specificity imaging manifestations, but it was detected early combining with a variety of imaging manifestation.
【关键词】乳腺放射状瘢痕;乳腺癌;病理活检;X线;MRI
【中图分类号】R737.9
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.01.022
前言
乳腺放射状瘢痕(Radial scars RS)又被称为放射状硬化性病变, (Radial sclerosing lesions RSL)是一种良性假浸润性病变,其发病 机制目前尚不清楚,可能与乳腺组织硬化,乳腺小叶结构破坏有关。 主要好发于40-60岁之间的人群,30岁前发病者较少。在乳腺X线普查 人群中仅为0.03%~0.09%,但是在尸体解剖研究中乳腺放射状瘢痕的 发病率可高达28%[1-2]。而乳腺放射状瘢痕具有发展为浸润性癌灶和原 位性导管癌的潜能,其临床表现缺乏特异性,多数患者有不能触及或 较小的肿块,呈多发性或双侧性[2]。因此,选择合适的辅助检查对于 早期诊断乳腺放射状瘢痕具有重要作用。
中国CT和MRI杂志
第15卷, 第 1 期
2017年01月
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