Imaging Diagnosis of Intraductal Papillomas of the Breast

乳管內乳頭狀瘤之影像診斷

徐先和(Hsian-He Hsu) ； 許居誠(Giu-Cheng Hsu) ； 沈宏儒(Hung-Ju Shen) ； 秦嗣騏(Shy-Chyi Chin) ； 蕭海松(Hai-Sung Hsiao) ； 俞志誠(Jyh-Cherng Yu) ； 阮春榮(Chun-Jung Juan) ； 薛俊仁(Chun-Jen Hsian)

《中華放射線醫學雜誌》 23卷5期 (1998/10) Pp. 177-181

摘要

在過去5年半中，我們分析了52位病理診斷確定為乳管內乳頭狀瘤的臨床症狀及影像學表徵（包括乳房攝影、超音波及乳管攝影）。這些病人最常見的臨床症狀為乳頭有分泌物（佔60%），且乳房攝影一般是正常的（佔52%）。在我們分析的52位乳房超音波檢查中，有49(94%)位病人顯示異常；異常超音波的表徵包括乳管擴張合併或沒有合併乳管內實質回音部份（佔35%）、只有實質腫瘤（佔27%）、實質腫瘤連接到擴張的乳管（佔22%）及水囊性病灶合併囊壁內突出的實質腫瘤部份（佔16%）。24位接受乳管攝影檢查的病人均顯示異常之發現；其中包括乳管內填充缺陷合併有乳管擴張（佔88%）、單純的乳管阻塞而沒有乳管內填充缺陷（佔8%）及單純的乳管擴張（佔4%）。我們總結的認為乳房超音波對於偵測乳管內的病灶是有幫助的，並可提供許多對乳管內乳頭狀瘤有診斷價值的超音波表徵。而乳管攝影對於乳管內乳頭狀瘤的病灶位置及擴張程度，確實地提供了一個清楚的術前影像，可給外科醫師手術時有一個很好的參考藍圖。

關鍵字

乳管 ； 乳房攝影 ； 乳房超音波 ； 乳頭狀瘤

並列摘要

Intraductal papilloma of the breast is a common benign mammary tumor and is one of the most common tumor associated with nipple discharge in woman. Patients with these lesions have an increased risk for the development of breast cancer. Our purpose was to determine the imaging features of intraductal papillomas of the breast and to assess their role in the evaluation of these patients. The clinical presentation and imaging findings, including mammography, ultrasonography, and ductography were retrospectively reviewed in 52 patients with histologically proven intraductal papillomas of the breast. Patients with these lesions commonly had nipple discharge (60%) and normal mammographic findings (52%). Ultrasonography identified abnormalities in 49 of 52 (94%) ultrasonograms. Dilated ducts with or without intraluminal echoes were noted in 17/49(35%) ultrasonograms, solid masses only in 13/49(27%), solid masses connected with dilated ducts in 11/49(22%), and cystic lesions with intracystic solid components in 8/49(16%). Findings were abnormal in all 24 ductograms, including both intraluminal filling defects and duct dilatation in 21 (88%) patients, total obstruction of the duct in 2(8%) patients, and only duct ectasia in 1(4%) patient. We conclude that ultrasonography is useful in the detection of intraductal lesions and contributes considerably to the diagnosis. Ductography can complement surgical excision by mapping the course of abnormal ducts and showing the location and full extent of intraductal papillomas.

並列關鍵字

Breast, ducts ； Breast neoplasms ； Mammography ； Breast, ultrasonography, papillomas