乳腺髓样癌的超声特征分析及其鉴别诊断

The Ultrasonic Characteristics of Medullary Carcinoma of Breast

目的:通过乳腺髓样癌的超声声像图特征分析探讨超声对乳腺髓样癌的诊断价值。方法:回顾性分析2009年1月至2014年8月期间我院体检发现经手术病理证实的19位患者共19例髓样癌的超声声像图特征,总结其特征性表现并分析其误诊原因。结果:髓样癌超声上常表现为形态不规则的弱回声区,边缘多较不规整,内部回声分布多不甚均匀,可见不规则无回声或弱回声区,偶见细钙化;后方回声多增强,内部血流信号较丰富者也不少见。结论:髓样癌在超声上还是有一定特征性的,超声能帮助其与常见良性肿瘤如纤维腺瘤、实质性导管内乳头状瘤、叶状肿瘤等的鉴别诊断。

Purpose： To assess the value of ultrasonography in diagnosing medullary carcinoma and differentiating it from some common benign tumors. Methods： The ultrasound images of 19 patients with histologically proved medullary carcinoma since January 2009 to August 2014 were retrospectively analyzed. Results： The common sonographic features of medullary carcinoma were as follows： the shapes were always not regular; the margins were always not smooth, angularity or spicule signs could be seen; The inner echo was very low and always inhomogeneous, small anechoic or weak-echoic regions were commonly seen and dot-like high echoes could be seen occasionally in the lesions; The sign of posterior acoustic enhancement was not rare; Blood flow signals and streak blood stream signals could also be seen on CDFI. According to ACR BI-RADAS for ultrasound, the diagnostic accuracy of ultrasound was 78.9%. Conclusion： The characteristics of medullary carcinoma in ultrasound are helpful to differentiate medullary carcinoma from some common benign tumors such as fibroadenoma, solid intraductal papilloma and phyllodes tumor.