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[1]彭龍莊 翁宗杰 凌 文 黨婷婷 劉 敏.乳腺原位癌的超聲診斷與鑒別診斷[J].福建醫(yī)藥雜志,2020,42(05):19-22.
　PENG Longzhuang,WENG Zongjie,LING Wen,et al.Ultrasonic diagnosis and differential diagnosis of the breast carcinoma in situ[J].FUJIAN MEDICAL JOURNAL,2020,42(05):19-22.
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乳腺原位癌的超聲診斷與鑒別診斷()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期數(shù):
2020年05期
頁碼:
19-22
欄目:
臨床研究
出版日期:
2020-10-20

文章信息/Info

Title:
Ultrasonic diagnosis and differential diagnosis of the breast carcinoma in situ
文章編號:
1002-2600(2020)05-0019-05
作者:
彭龍莊 翁宗杰 凌 文 黨婷婷 劉 敏1
福建省婦幼保健院超聲科(福州 320001)
Author(s):
PENG Longzhuang; WENG Zongjie;  LING Wen;  DANG Tingting;  LIU Min
Department of Ultrasound, Fujian Maternity and Child Health Hospital, Fuzhou,Fujian 350001, China
關(guān)鍵詞:
乳腺原位癌;  超聲;  鑒別診斷
Keywords:
breast carcinoma in situ;  ultrasonography;  differential diagnosis
分類號:
R737.9
文獻標志碼:
B
摘要:
目的 分析乳腺原位癌(BCIS)的超聲聲像圖特征,探討其超聲診斷及鑒別診斷。方法 回顧性分析經(jīng)組織病理學證實的24個BCIS病灶、48個乳腺浸潤癌(IBC)病灶、59個術(shù)前超聲診斷為BI-RADS 4a級及以上的良性病灶的超聲聲像圖特征,對3組病灶的超聲表現(xiàn)進行對比分析。結(jié)果 BCIS與IBC的超聲聲像表現(xiàn)在導管擴張、內(nèi)部回聲、縱橫比≥0.7、邊界不清、邊緣毛刺、高回聲暈、后方回聲衰減、血流信號(Alder分級)、腋窩淋巴結(jié)異常方面差異有統(tǒng)計學意義(P<0.05),病灶內(nèi)檢出血流信號者,血流分布以邊緣為主的BCIS占76.9%(10/13),而IBC占25.0%(8/32),差異有統(tǒng)計學意義(P=0.001)。BCIS與良性病變比較,其后方回聲增強比率較良性病變低(P<0.01),邊界不清及鈣化比率較良性病變高(P<0.05),檢出鈣化的病灶中,鈣化灶直徑<0.5 mm的BCIS占100%(10/10),良性病變占33.3%(3/9),差異有統(tǒng)計學意義(P=0.002)。術(shù)前超聲診斷BCIS的準確率為37.5%(9/24),其中13個誤診為良性,2個未定性。結(jié)論 BCIS病灶常缺乏典型的惡性征象,超聲診斷較困難,多切面仔細觀察病灶的邊界、邊緣、內(nèi)部回聲、后方回聲、鈣化、導管擴張及血流情況等,對鑒別乳腺良惡性病灶、及時發(fā)現(xiàn)早期癌變有一定的意義。
Abstract:
Objective To analyze the ultrasonographic features of the breast carcinoma in situ(BCIS), and to discuss its ultrasonic diagnosis and differential diagnosis.Methods Twenty-one patients with 24 lesions of breast carcinoma in situ and 40 patients with 48 lesions of invasive breast carcinomas(IBC)and 57 patients with 59 benign lesions which preoperative ultrasound examination for BI-RADS 4a grade or above were enrolled in this study.All these cases had been verified by ultrasound guided breast biopsy or surgical pathology.The sonographic features were retrospectively reviewed between the three groups with universally accepted standards.Results The ultrasonic characteristic of BCIS and IBC showed statistical differences in duct ectasia, internal echo, A/T≥0.7, obscure boundary,speculated margin, peripheral hyperechoic halo, posterior echo attenuation, blood flow(Alder hierarchical)and axillary adenopathy(P<0.05).Among the lesions whose blood flow signals were detected, the peripheral blood distribution of BCIS accounted for 76.9%(10/13), while IBC accounted for 25.0%(8/32),the difference was statistically significant(P=0.001).Compared with benign lesions, the posterior echo enhancement rate of BCIS was lower(P<0.01), the percentage of obscure boundary and calcification in BCIS were significantly higher than those in benign lesions(P<0.05).For the lesions whose were detected calcification, BCIS accounted for 100%(10/10)and benign lesions accounted for 33.3%(3/9)with the diameter of calcification <0.5 cm,and the difference was statistically significant(P=0.002).The accuracy rate of preoperative ultrasound diagnosis of BCIS was 37.5%(9/24), among which 13 cases were misdiagnosed as benign and 2 cases were undefined.Conclusion BCIS often lack typical malignant features, which makes ultrasonic diagnosis difficult.Observing of the boundary, edge, internal echo, posterior echo, calcification, ductal dilatation and color flow characteristics in multiple sections is significant for the differential diagnosis of breast lesions and the timely detection of early canceration.

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更新日期/Last Update: 2020-10-20