超声诊断男性乳腺发育症及其某些发病规律探讨

发布时间：2018-07-31 06:32

【摘要】：研究背景及目的：近年来女性乳腺疾病越来越多地得到了大家的重视,随着健康知识的普及、保健意识的增强,女性乳腺癌的防治工作得到了广泛的关注；相比较而言,男性乳腺疾病却往往容易忽视,其中男性乳腺发育症是最为常见的男性乳腺疾病。男性乳腺发育症是指男性乳腺腺体组织良性增厚、呈妇乳样改变,可发生于任何年龄。据流行病学报道,其流行率在国外男性人群可达32%-65%。超声诊断男性乳腺发育症的回顾性总结和前瞻性研究在国内开展得比较少,国外的相关文献比较零散,且国内男性与西方白色人种男性患乳腺疾病或许存在差异,我们亦需要国人自己的数据。本研究目的在探讨超声诊断、随访监测男性乳腺发育症的重要临床价值,并分析通过超声诊断的男性乳腺发育症资料,发现并探讨其患病年龄、检查年份及单双侧分布等相关发病规律。方法：选择在我院2005年1月-2013年12月接受乳腺超声检查的178例男性患者,年龄3-98岁,平均36.8+21.7岁；其中超声诊断为男性乳腺发育症145例,年龄3-98岁,平均35.8±21.1岁。分析并总结经病理证实或临床确诊的145例男性乳腺发育的超声声像图特异性表现,并将超声诊断与病理及随访结果对照。将所有资料的基本情况、超声检查所见与结果输入计算机excel文件,整理分组进行统计。所有男性乳腺发育患者根据年龄分≤19岁、20-39岁、40-59岁、60-79岁、≥80岁5组；≤30岁和30岁两组；20-39岁和非此年龄段两组；根据检查年份分2005年、2006年、2007年、2008年、2009年、2010年、2011年、2012年、2013年共9组。采用SPSS19.0统计软件进行分析。采用矛检验分析患者在不同年龄组、不同检查年份的分布情况,以P0.05为差异有统计学意义。用统计学频数分布图观察检查者单双侧患病分布情况。结果：本组145例男性乳腺发育症患者中,95例为单侧(95/145,65.52%),其中左侧乳腺发育57例,右侧38例；50例为双侧(其中1例为左侧病变发展至双侧),超声声像图均显示为不同程度的乳腺腺体增厚,长径约2.1～6.6cm,平均长径3.38+0.92cm；厚约0.50～2.90cm,平均0.78+0.30cm。男性乳腺发育症超声声像图特点：乳头下方、乳晕周围可见增厚的乳腺腺体组织回声,可呈低回声或稍高回声或蜂窝状回声,边界尚清,无包膜,与前方皮下脂肪组织及后方胸大肌分界可见,内部回声尚均匀或欠均匀,无明显强回声钙化灶。彩色多普勒血流显像(CDFI)显示：腺体内及周边血流信号不丰富。结论：本研究通过分析145例男性乳腺发育症的超声声像图特点,对照病理及随访结果,并统计学分析其患病年龄、检查年份、单双侧的分布,结论如下： 1.超声可诊断和鉴别诊断男性乳腺发育症,是首选检查方法。 2.超声具有随访和评价男性乳腺发育治疗效果的优势。 3.本组研究首次发现男性乳腺发育症患者多发于20～39岁年龄段。 4.本组研究首次发现近年来男性乳腺发育症患病呈增长趋势,于2013年最多。 5.本组研究单侧乳腺发育最常见(95/145,65.52%)。
[Abstract]:Research background and purpose:
In recent years, women's breast disease has been paid more and more attention. With the popularization of health knowledge and the enhancement of health awareness, the prevention and treatment of female breast cancer has been widely paid attention. In comparison, male breast disease is often ignored, and male mammary gland development is the most common male breast disease.
Male mammary gland development refers to the benign thickening of the gland tissue of the male mammary gland, which can occur at any age. According to the epidemiological report, the prevalence rate in the male population of foreign men can reach 32%-65%. ultrasonography in the diagnosis of male mammary gland development. More scattered, and there may be differences in breast disease between domestic and western white men, we need our own data.
The purpose of this study is to explore the important clinical value of ultrasound diagnosis and follow-up monitoring of male mammary gland development, and to explore and explore the age of the disease, the year and the distribution of single side and bilateral distribution, and to analyze the data of male mammary gland development by ultrasound.
Method:
178 male patients, aged 3-98 years and 36.8+21.7 years old, were selected in our hospital in January 2005 -2013 December. Among them, 145 cases of male mammary gland development, 3-98 years old and average 35.8 + 21.1 years old, were diagnosed by ultrasound. The ultrasonographic features of 145 male mammary gland development confirmed by pathology or clinical diagnosis were analyzed and summarized. The ultrasonographic diagnosis was compared with pathology and follow-up results.
The basic situation of all the data, the ultrasound examination and the results entered the computer excel file, sorting out the statistics. All male breast development patients according to the age of 19 years, 20-39 years old, 40-59, 60-79, 80 years of 5 groups; less than 30 years and 30 years of two groups; 20-39 years and non age group two; according to the year of examination, 2006, 2006, 2005, 2006. In 2007, 2008, 2008, 2009, 2010, 2011, 2012, and 2013, the 9 groups were analyzed with SPSS19.0 software. The distribution of patients in different age groups and different examination years was analyzed by spear test. The difference was statistically significant with the difference of P0.05.
Result:
Of the 145 male patients with mammary gland development, 95 were unilateral (95/145,65.52%), of which 57 were developed in the left side of the breast, 38 in the right, and 50 in the bilateral (1 of the left lesions developed to bilateral). The ultrasonographic map showed the thickening of the glands of the breast in varying degrees, the length of the diameter of about 2.1 to 6.6cm, the average length of 3.38+0.92cm, and the thickness of about 0.50 to 2.90. Cm, average 0.78+0.30cm.
Characteristics of ultrasonic image of male mammary gland development: below the nipple, the echo of thickened mammary gland tissue around the corola can be seen around the mammary gland. It can be hypoechoic or slightly hyperechoic or honeycomb echo, the boundary is clear, no capsule, and the boundary between the anterior subcutaneous adipose tissue and the posterior pectoralis major muscle is visible, the internal echo is even or less homogeneous, and there is no obvious echo calcification. Color Doppler flow imaging (CDFI) showed that the blood flow signals in and around the glands were not abundant.
In this study, we analyzed the ultrasonographic features of 145 cases of male mammary gland development, compared the pathological and follow-up results, and analyzed the age of the disease, examined the year, and the distribution of the single bilateral. The conclusions are as follows:
1. ultrasound is the first choice for the diagnosis and differential diagnosis of gynecomastia.
2. ultrasound has the advantage of follow-up and evaluation of male breast development.
3. for the first time, male patients with breast development were found in the age group of 20~39.
4. the first study found that the incidence of gynecomastia increased in recent years, the most in 2013.
5. in this group, unilateral breast development is the most common (95/145,65.52%).
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R655.8;R445.1

【相似文献】