[1]彭龙庄 翁宗杰 凌 文 党婷婷 刘 敏.乳腺原位癌的超声诊断与鉴别诊断[J].福建医药杂志,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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乳腺原位癌的超声诊断与鉴别诊断()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期数:
2020年05期
页码:
19-22
栏目:
临床研究
出版日期:
2020-10-20

文章信息/Info

Title:
Ultrasonic diagnosis and differential diagnosis of the breast carcinoma in situ
文章编号:
1002-2600(2020)05-0019-05
作者:
彭龙庄 翁宗杰 凌 文 党婷婷 刘 敏1
福建省妇幼保健院超声科(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
关键词:
乳腺原位癌;  超声;  鉴别诊断
Keywords:
breast carcinoma in situ;  ultrasonography;  differential diagnosis
分类号:
R737.9
文献标志码:
B
摘要:
目的 分析乳腺原位癌(BCIS)的超声声像图特征,探讨其超声诊断及鉴别诊断。方法 回顾性分析经组织病理学证实的24个BCIS病灶、48个乳腺浸润癌(IBC)病灶、59个术前超声诊断为BI-RADS 4a级及以上的良性病灶的超声声像图特征,对3组病灶的超声表现进行对比分析。结果 BCIS与IBC的超声声像表现在导管扩张、内部回声、纵横比≥0.7、边界不清、边缘毛刺、高回声晕、后方回声衰减、血流信号(Alder分级)、腋窝淋巴结异常方面差异有统计学意义(P<0.05),病灶内检出血流信号者,血流分布以边缘为主的BCIS占76.9%(10/13),而IBC占25.0%(8/32),差异有统计学意义(P=0.001)。BCIS与良性病变比较,其后方回声增强比率较良性病变低(P<0.01),边界不清及钙化比率较良性病变高(P<0.05),检出钙化的病灶中,钙化灶直径<0.5 mm的BCIS占100%(10/10),良性病变占33.3%(3/9),差异有统计学意义(P=0.002)。术前超声诊断BCIS的准确率为37.5%(9/24),其中13个误诊为良性,2个未定性。结论 BCIS病灶常缺乏典型的恶性征象,超声诊断较困难,多切面仔细观察病灶的边界、边缘、内部回声、后方回声、钙化、导管扩张及血流情况等,对鉴别乳腺良恶性病灶、及时发现早期癌变有一定的意义。
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