高频彩超对小乳腺癌及腋窝转移性淋巴结的诊断价值

Diagnostic value of small breast carcinoma and axillary metastatic lymph node with high frequency color Doppler ultrasonography

目的探讨高频彩超对小乳腺癌及腋窝转移性淋巴结的诊断价值。方法对经手术病理证实的39例≤2 cm的小乳腺癌和21枚腋窝癌性转移性淋巴结的高频声像图及彩超特征进行回顾性分析。结果小乳腺癌的二维声像图特点内部呈低回声,无强回声包膜,能量多普勒显示以Ⅱ～Ⅲ级血流为主,穿入性血流及不规则血流分别为69.2%和53.8%,另外脉冲多普勒频谱阻力指数RI≥0.70具有较高的阳性预测值。腋窝癌转移性淋巴结声像图特征:淋巴结肿大,内部均匀低回声,周边及内部见血流信号。结论高频二维超声结合能量多普勒血流特征及频谱多普勒可以提高诊断小乳癌及腋窝转移性淋巴结的准确性。

Objective To evaluate the value of high frequency color Doppler uhrasonography （HFCDU） in diagnosis of small breast carcinoma and axillary metastatic lymph nodes. Methods The feature of 39 small breast carcinoma（diameter≤ 2 cm） and 21 lymph nodes proved by pathology examed by HFCDU were analyzed retrospectively. Results The small breast carcinoma was hypoechoic inside on high frequency ultrasonography, but there was no hyperechoic capsule. Power Doppler imaging showed that vessel patterns were grade Ⅱ -Ⅲ mainly. The penetrating and disordered vessels were easily seen, detecting rates were 69.2% and 53.8% respectively. In addition, the resistant index （RI） ≥0.70 on pulsed wave Doppler implied much more positive malignancy prediction. The ultrasonography characteristics of axillary metastatic lymph node were enlarged and low internal-echo. Blood flow was seen inside and arounding. Conclusion High frequency uhrasonography integrated with power Doppler imaging and pulsed wave Doppler can be used in early and accurate diagnosis of the small breast carcinoma and axillary metastatic lymph nodes.