【摘要】 目的 探讨CT和钼靶摄影在诊断乳腺癌中的价值。方法 收集23例乳腺癌，均为术后病理证实。钼靶采用美国GE公司Senographe2000D全数字化乳腺X线摄影机进行头尾位和中侧斜位进行双乳摄影，必要时加照中侧位和局部点压放大及其他特殊体位摄影。CT采用Somatom AR.SP螺旋CT机进行平扫和增强扫描，扫描范围从腋窝顶部至乳房下界。23例全部采用增强扫描，分别在注射造影剂100ml后30s、60s、90s时进行动脉相、静脉相、延迟相CT扫描, 病人采用俯卧位，上胸及腹部垫高,使乳房自然下垂,双前臂交叉放在头上。结果 钼靶对乳腺癌诊断率为78.3%，钼靶和CT 结合达到91.3%。在显示病变与周围组织的关系、腋窝淋巴结、观察病变的血流动力学改变及小而致密的乳腺或贴近胸壁的病变，CT优于钼靶。对微小钙化的显示，钼靶比CT敏感。结论 临床可疑乳腺癌病例先进行钼靶摄影，必要时进行CT增强扫描，二者结合可明显提高诊断率。

    【关键词】 乳腺癌；体层摄影术；X线计算机；钼靶摄影

    【Abstract】 Objective To study the value of CT and mammography for diagnosing breast cancer.Methods 23 cases breast cancer were proved by pathology.All cases were examined using FFDM(Senographe2000D,GE).Craniocaudal view and mediolateral oblique were conducted for each patient.If necessary,mediolateral view or spot view was operated. All cases take plain scanner and contrast-enchanced scanner with use of a helical CT (Somatom AR.SP).For a patient,a field view was chosen that field depict the whole breast,as well as the ipsilateral axillary and internal mammary chains.Results The diagnostic accuracy of mammography and mammography combined with CT scan was respectively 78.3% and 91.3%.CT scan was superior to mammography in the relation between lump and connecting tissue,chest-wall invasion,axillary lymph nodes,small breast and the lump`s haemodynamic variation.In detecting microcalcification,the CT was worse than mammography in the sensitivity.Conclusion At first,the patient suspected of small breast cancer should take mammography.The case examined CT plain scan and contrast-enchanced scan if necessary.The mammography combined with CT scan can improve the diagnostic rate of breast cancer. ......