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目的探讨如何提高不典型乳腺癌X线诊断的准确率,减少误诊、漏诊。方法回顾性分析138例经病理证实的乳腺病变患者中14例乳腺数字钼靶X线片误诊的原因。结果误诊的14例占总乳腺病变患者的10.1%。在钼靶片上,3例浸润性导管癌病灶微小且位于增生的致密腺体内;1例浸润性导管癌无肿块影;1例良性病变术后病灶被掩盖;2例单纯癌可见肿块,密度均匀,边缘清晰;1例不典型髓样癌影像缺乏密度差,以上8例被误诊为良性病变。4例慢性乳腺炎并囊肿形成,钼靶片上可见肿块直径2.5～5.0cm,边缘毛糙;1例纤维腺瘤,似见慧星尾征,局部腺体略聚拢;1例不典型增生,可见不规则高密度块影和毛刺,以上6例均误诊为乳腺癌。结论 CR钼靶对不典型乳腺癌及致密型乳腺的诊断有一定困难,在读片时应注意对小病灶及局部结构紊乱征象的发现,必要时结合X线立体定位穿刺活检,对提高乳腺癌X线钼靶诊断准确率,减少误诊及漏诊有重要意义。
Objective To explore how to improve the accuracy of X-ray diagnosis of atypical breast cancer and reduce misdiagnosis and missed diagnosis. Methods Retrospective analysis of 138 cases of pathologically confirmed breast lesions in 14 cases of mammography digital mammography misdiagnosis reasons. Results misdiagnosed 14 cases accounted for 10.1% of patients with total breast lesions. On the molybdenum target, three cases of infiltrating ductal carcinoma were small and located in dense glandular hyperplasia. One case of invasive ductal carcinoma showed no mass and one case of benign lesion was covered. Two cases of simple carcinoma showed lumps, Uniform, clear edge; 1 case of atypical medullary carcinoma lacks density, more than 8 cases were misdiagnosed as benign lesions. 4 cases of chronic mastitis and cyst formation, molybdenum target film showed the mass diameter of 2.5 ~ 5.0cm, rough edges; 1 case of fibroadenoma, see the Comet tail sign, local gland convergence slightly; 1 case of atypical hyperplasia, can be seen not Rules of high-density block shadow and burr, more than 6 cases were misdiagnosed as breast cancer. Conclusion The CR molybdenum target has some difficulties in the diagnosis of atypical breast cancer and compact breast. During the reading, attention should be paid to the discovery of small lesions and signs of local structural disorders. If necessary, combined with X-ray stereotactic biopsy, Line molybdenum target diagnostic accuracy, reduce misdiagnosis and missed diagnosis is of great significance.