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目的探讨乳腺X线不对称征象结合触诊对乳腺病变的定性诊断价值。方法收集经手术病理或穿刺活检证实的135例X线表现为不对称征象的患者资料,对比分析不对称征象及触诊在乳腺各种病变诊断中的差异。结果135例中,乳腺腺病63例,触及肿块35例,质韧者29例;不对称致密影呈等密度45例,伴结构扭曲11例,乳腺炎性病变33例,触及肿块29例,质硬、活动度差;不对称致密影呈高密度26例;乳腺恶性肿瘤39例,触及肿块34例,质硬者31例,活动度差者32例,不对称致密影呈高密度31例,伴结构扭曲26例。临床触诊诊断符合率64.4%;单独分析不对称征象,诊断符合率79.3%;二者联合应用诊断符合率91.1%,能大大提高诊断符合率。三种病变的X线不对称征象的差异有显著的统计学意义(P<0.05)。结论乳腺腺病、炎症和乳腺癌引起的不对称征象各有一定的影像特征,结合触诊可以提高该征象的定性诊断水平。
Objective To investigate the diagnostic value of breast X-ray asymmetry combined with palpation in the diagnosis of breast lesions. Methods The data of 135 cases with asymptomatic X-ray confirmed by pathology or biopsy were collected, and the differences between the asymmetric signs and the diagnosis of various breast lesions were analyzed. Results Of the 135 cases, 63 cases of breast adenosis, 35 cases of tumor mass, and 29 cases of mass-toughness. Asymmetric densification showed an equal density of 45 cases with structural distortions in 11 cases, mastitis lesions in 33 cases and palpable masses in 29 cases, Hard and poor activity; asymmetric dense shadow was 26 cases of high density; breast cancer in 39 cases, touching the mass in 34 cases, 31 cases of hard quality, 32 cases of poor activity, asymmetric dense shadow was 31 cases of high density , Accompanied by structural distortion in 26 cases. The accuracy of clinical palpation diagnosis was 64.4%. Asymmetric symptoms were analyzed separately and the diagnostic coincidence rate was 79.3%. The diagnostic coincidence rate of 91.1% in combination with the two methods could greatly improve the diagnostic coincidence rate. The differences of X-ray asymmetry between the three lesions were statistically significant (P <0.05). Conclusion The breast adenosis, inflammation and breast cancer caused by asymmetric signs have certain imaging features, combined with palpation can improve the qualitative diagnosis of the signs.