Sonnenblick Emily B, Salvatore Mary, Szabo Janet, Lee Karen A, Margolies Laurie R
1 Department of Radiology, Section of Breast Imaging, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl, New York, NY 10029.
2 Department of Radiology, Section of Chest Imaging, Icahn School of Medicine at Mount Sinai, New York, NY.
AJR Am J Roentgenol. 2016 Aug;207(2):234-40. doi: 10.2214/AJR.15.15877. Epub 2016 Apr 21.
The purpose of this study was to determine whether additional breast imaging is clinically valuable in the evaluation of patients with gynecomastia incidentally observed on CT of the chest.
In a retrospective analysis, 62 men were identified who had a mammographic diagnosis of gynecomastia and had also undergone CT within 8 months (median, 2 months). We compared the imaging findings of both modalities and correlated them with the clinical outcome.
Gynecomastia was statistically significantly larger on mammograms than on CT images; however, there was a high level of concordance in morphologic features and distribution of gynecomastia between mammography and CT. In only one case was gynecomastia evident on mammographic but not CT images, owing to cachexia. Two of the 62 men had ductal carcinoma, which was obscured by gynecomastia. Both of these patients had symptoms suggesting malignancy.
The appearance of gynecomastia on CT scans and mammograms was highly correlated. Mammography performed within 8 months of CT is unlikely to reveal cancer unless there is a suspicious clinical finding or a breast mass eccentric to the nipple. Men with clinical symptoms of gynecomastia do not need additional imaging with mammography to confirm the diagnosis if they have undergone recent cross-sectional imaging.
本研究的目的是确定在胸部CT检查时偶然发现男性乳房肥大的患者中，额外的乳房成像在评估中是否具有临床价值。
在一项回顾性分析中，确定了62名男性，他们经乳房X线摄影诊断为男性乳房肥大，且在8个月内（中位数为2个月）也进行了CT检查。我们比较了两种检查方式的影像学表现，并将其与临床结果相关联。
从统计学角度来看，男性乳房肥大在乳房X线照片上比在CT图像上更大；然而，乳房X线摄影和CT在男性乳房肥大的形态特征和分布方面具有高度一致性。仅1例因恶病质导致男性乳房肥大在乳房X线照片上明显而在CT图像上不明显。62名男性中有2例患有导管癌，被男性乳房肥大掩盖。这两名患者均有提示恶性肿瘤的症状。
CT扫描和乳房X线照片上男性乳房肥大的表现高度相关。在CT检查后8个月内进行乳房X线摄影不太可能发现癌症，除非有可疑的临床发现或乳头旁有乳房肿块。有男性乳房肥大临床症状的男性如果近期已进行横断面成像，则无需额外的乳房X线摄影来确诊。
