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1、華南國(guó)防醫(yī)學(xué)雜志2015年9月28日第29卷第9期MilMedJSChin,Vol.29,No.9,September28,2015·669·X線不對(duì)稱(chēng)征象結(jié)合觸診在乳腺癌篩查中的價(jià)值汪興龍,夏玉明,胡必富,劉長(zhǎng)華,嚴(yán)君【摘要】目的探討乳腺X線不對(duì)稱(chēng)征象結(jié)合觸診對(duì)乳腺病變的定性診斷價(jià)值。方法收集經(jīng)手術(shù)病理或穿刺活檢證實(shí)的135例X線表現(xiàn)為不對(duì)稱(chēng)征象的患者資料,對(duì)比分析不對(duì)稱(chēng)征象及觸診在乳腺各種病變?cè)\斷中的差異。結(jié)果135例中,乳腺腺?。叮忱?,觸及腫塊35例,質(zhì)韌者29例;不對(duì)稱(chēng)致密影呈等密度45例,伴結(jié)構(gòu)扭曲11例,乳腺炎性病變33例,觸及腫塊
2、29例,質(zhì)硬、活動(dòng)度差;不對(duì)稱(chēng)致密影呈高密度26例;乳腺惡性腫瘤39例,觸及腫塊34例,質(zhì)硬者31例,活動(dòng)度差者32例,不對(duì)稱(chēng)致密影呈高密度31例,伴結(jié)構(gòu)扭曲26例。臨床觸診診斷符合率64.4%;單獨(dú)分析不對(duì)稱(chēng)征象,診斷符合率79.3%;二者聯(lián)合應(yīng)用診斷符合率91.1%,能大大提高診斷符合率。三種病變的X線不對(duì)稱(chēng)征象的差異有顯著的統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論乳腺腺病、炎癥和乳腺癌引起的不對(duì)稱(chēng)征象各有一定的影像特征,結(jié)合觸診可以提高該征象的定性診斷水平。【關(guān)鍵詞】局灶性;不對(duì)稱(chēng);乳腺X線攝影;乳腺癌篩查【中圖分類(lèi)號(hào)】R737.9【文獻(xiàn)標(biāo)識(shí)碼】
3、Adoi:10.3969/jissn.1009.-2595.2015.09.007SignificantValueofX-rayMammographyCombinedwithPalpationExaminationinBreastCancerScreeningWANGXing-long,XIAYu-ming,HUBi-fu,LIUChang-hua,YANJun.DepartmentofRadiology,SuizhouMaternalandChildHealth-careHospital,SuizhouHubei441300,China【Ab
4、stract】ObjectiveToevaluatethevalueofX-raymammographycombinedwithpalpationexaminationindiag-nosingbreastlesions.MethodsCollectingtheinformationof135patientswithsurgeryandpathologyoraspirationbiopsyconfirmed,whohadasymmetrymanifestationsintheX-raymammography,tocomparethediffer
5、entvaluesbetweenX-raymammographyandpalpationindiagnosingbreastlesions.ResultsTherewere63mammarydysplasiacasesinthe135patients,amongwhichpalpablemasseswere35,tenaciousbreastswere29,andtheX-rayappearanceofequaldensitypyknic-shadowwere45,X-rayappearanceofdistortionwere11,amongw
6、hichpalpablemasseswere29withfirmbreasts,andtheX-rayappearanceofhighdensitypyknic-shadowwere26.Therewere39malignantbreasttumorcasesinthe135patients,amongwhichpalpablemasseswere34,firmbreastswere31,poormobilitywere32andtheX-rayappearanceofhighdensitypyknic-shadowwere31,X-rayap
7、pearanceofdistortionwere26.Thediagnosticcoincidencerateofclinicalpal-pationwas64.4%,andtherateofasymmetricsignsintheX-raymammographywas79.3%.Whenclinicalpalpationcombinedwiththeasymmetricsign,thediagnosticcoincidenceraterisedto91.1%.Therewassignificantdifferencebe-tweenclini
8、calpalpationandtheasymmetricsignsinthreekindsofdiseases(P<0.05).ConclusionT