乳腺叶状肿瘤19例高频超声特征

High frequency sonographic features of breast phyllodes tumors

目的探讨乳腺叶状肿瘤的高频超声特征及其在诊断中的应用价值.方法对我院经术前超声检查及手术治疗的19例乳腺叶状肿瘤患者的病例资料进行回顾性分析.结果术前超声所测19例肿块最大径范围2～18cm(平均6.4cm).其中良性肿块范围为2～8cm,平均4.8cm;交界性肿块范围为4～18cm,平均9.6cm;恶性肿块范围为4～8cm,平均6.5cm.二维超声:19例肿块均为低回声,内部回声均匀或不均匀,14例边界清楚,13例可见薄包膜回声,1例肿块呈椭圆形,5例轻度分叶,13例明显分叶,1例内部见微小钙化,13例肿瘤实质内可见高回声分隔,11例内部见不规则无回声区,17例出现后方回声增强,14例有侧壁声影.彩色多普勒血流成像(CDFI):19例肿瘤内可探及Ⅱ～Ⅲ级血流信号.术后病理证实19例乳腺叶状肿瘤(良性10例、交界性5例、恶性4例)位于左乳11例,右乳8例,3例伴有多发纤维腺瘤.结论乳腺叶状肿瘤高频超声表现有一定的特点,但这些表现不具有特征性.乳腺良性、交界性与恶性叶状肿瘤超声表现无明显差别.CDFI对乳腺叶状肿瘤良性与恶性的鉴别、纤维腺瘤与乳腺叶状肿瘤的鉴别诊断均有帮助,但仍需进一步研究.

Objective The aim of this study was to investigate the high-frequency sonographic features of breast phyllodes tumors. Methods The sonographic features of 19 patients with phyllodes tumors (10 benign, 5 borderline, 4 malignant) confirmed by surgery and histopathology in our hospital during Jan 2003 - Aug 2005 were reviewed retrospectively. Results Of 19 phyllodes tumors, 11 tumors occurred in the left , and 8 in the right. The longest dimension of the tumors varied from 2 to 18 cm (median 6.4 cm), and dimensions did not differ significantly betwean the benign (range 2-8 cm, median 4.8 cm), borderline (range 4-18 cm, median 9.6 cm), and malignant (range 4-8 cm, median 6.5 cm) tumors. On sonography, all tumors were homogeneous or heterogeneous hypoechoic, fourteen of them were with defined border, and thirteen had a thin echoic capsule; 1 was oval, 5 lobulated and thirteen multi-lobulated, 13 showed intramural hyperechoic septum; cystic areas were found in 11 of 19 tumors, 17 showed posterior acoustic ehhancement and 14 showed lateral edge shadowing. Blood vessels were detectable in all 19 tumors (blood flow grade: Ⅱ-Ⅲ). Conclusions High-frequency sonographic features of breast phyllodes are characteristic but not pathognomonic. Sonography can hardly distinguish between benign, borderline and malignant phyllodes tumors.