Abstract
目的 探讨乳腺脂肪坏死的X线表现及病理基础,提高对脂肪坏死的认识.方法回顾性分析经手术、病理证实的91例(其中2例为双侧乳腺脂肪坏死,共93个病变.)脂肪坏死X线表现,并与病理结果对照.结果主要X线表现:(1)无任何异常X线发现14例(15.4%);(2)脂性囊肿6例(6.6%);(3)表现为肿物20例(22.0%),其中1例为双侧乳腺脂肪坏死;(4)表现为小结节13例(14.3%);(5)脂肪层内星芒影、斑片影、索条影混杂出现28例(30.8%),其中1例为双侧乳腺脂肪坏死;(6)脂肪层内索条影交织呈网状5例(5.5%);(7)结构不良者5例(5.5%).分布部位:(1) 位于脂肪层内55例;(2)向脂肪层突出或位于脂肪层与腺体交界处13例,常规位摄片位于脂肪层与腺体交界处的脂肪坏死,切线位投照有利于将病变显示于脂肪层内;(3)位于腺体之间9例;(4)乳腺平片未见异常发现14例.病理表现:(1)脂性囊肿是病变早期的特征性X线表现.(2)脂肪层内不均匀密度肿物影或小结节影为病变中期的特征性表现,反应了纤维组织逐渐替代了液化坏死的脂肪组织.(3)脂肪层内或浅层腺体内局限星芒状致密影以及不规则的网状影最常见,是病变后期的特征性表现.反应了坏死脂肪组织被吸收,周围残留部分纤维组织.通常不同病理时期的X线表现常同时出现.结论乳腺X线摄影对于脂肪坏死具有重要诊断价值。
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