乳腺腺病X线磁共振传统影像诊断的回顾与新发现

周丽萍　朱继红

[摘要] 近年来，我国乳腺腺病的发生率呈快速上升的趋势。究其原因，一方面可能与我国经济社会结构转型背景下，妇女生育年龄推迟、母乳喂养次数减少、超重肥胖、缺乏运动有关;另一方面也得益于我国乳腺疾病早期诊断技术的进步及筛查理念的推广。作为一种常见的乳腺良性疾病，人们对乳腺腺病的认识已经过了百余年之久，但其与乳腺癌的关系目前并不十分明确。乳腺腺病的诊断;依赖于影像医师的临床经验水平。正确的影像诊断，乳腺腺病的早期检出、及时干预、临床随访及疗效评价，甚至避免过度检查治疗均具有巨大的意义。本文拟对乳腺腺病的X线、磁共振等传统影像学诊断进行综述回顾，并结合笔者在临床工作中的一些经验体会进行简单论述。

[关键词] 乳腺腺病;乳腺癌;X线;磁共振

[中图分类号] R445          [文献标识码] A          [文章编号] 1673-9701（2021）20-0188-05

Retrospect and new discovery of traditional X-ray magnetic resonance imaging diagnosis of breast adenosis

ZHOU Liping   ZHU Jihong

Department of Radiology， Yulin First People′s Hospital in Guangxi Zhuang Autonomous Region，Yulin   537000，China

[Abstract] In recent years，the incidence of breast adenosis in my country has shown a rapid upward trend. The reasons may be related to the delayed childbearing age， reduced breastfeeding frequency， overweight and obesity， and lack of exercise in the context of the transformation of my country′s economic and social structure. On the other hand， it also benefits from the advances in early diagnosis technology and promotion of screening concepts for breast diseases in my country. As a common benign breast disease， people have been aware of breast adenosis for more than a hundred years， but its relationship with breast cancer is currently not very clear. The diagnosis of breast adenosis often depends on the level of clinical experience of imaging physicians. Correct imaging diagnosis， early detection of breast adenosis， timely intervention， clinical follow-up and efficacy evaluation， and even avoiding excessive examination and treatment are of great significance. This article intends to review the traditional imaging diagnosis of breast adenosis such as X-ray and magnetic resonance， and combine the author′s experience in clinical work to make a brief discussion.

[Key words] Breast adenosis; Breast cancer; X-ray; Magnetic resonance

乳腺腺病是一種慢性乳腺良性增生性疾病，1829年由英国的Astley Cooper首先对该病进行了描述，并将该病称为Callularhydatids，1972年我国的肿瘤防治办公室将该病归为“乳腺增生症”，现在世界卫生组织将该病定名为乳腺腺病。

乳腺腺病为乳腺良性疾病，预后良好，故其诊断并不常规推荐有创性活检;同时该类疾病并无有意义的实验室检查指标，因此，影像学成了诊断乳腺腺病的重要手段。尤其对于乳腺腺病和乳腺恶性疾病鉴别诊断，影像学检查具有举足轻重的地位。但笔者发现，在乳腺疾病影像学早期诊断和筛查工作中常有一些不尽人意的地方，尤其在基层医院，误诊、漏诊、过度检查的情况时有发生。乳腺腺病临床病理类型多样、病理和影像表现不统一的特性也给该疾病误诊带来客观难度。X线和磁共振是乳腺腺病诊断的最常用方法，因此，笔者翻阅了相关文献及统计资料，总结了该病的X线及磁共振表现特点，并结合笔者临床工作中总结出的体会心得加以阐述，以期为乳腺腺病规范化早期诊断提供理论依据。

1 乳腺增生症临床病理和影像学表现的相关性