超声及穿刺活检诊断乳腺癌肝转移的临床意义

Clinical significance of ultrasound and needle biopsy in diagnosis of breast cancer with liver metastasis

为了探讨乳腺癌肝转移的超声声像图特点,以及超声引导下穿刺活检在乳腺癌肝转移确诊中的临床意义,回顾性分析了105例乳腺癌肝转移的超声声像图特点及穿刺活检结果。乳腺癌肝转移声像图为实性结节或肿块,大多数为低回声(86.7%,91/105)。较小者(≤3 cm)形态多规整,边界清晰,内部回声多分布均匀;较大者(>3 cm)形态多不规整,边界模糊,内部回声多分布不均匀。血流信号不能作为诊断的重要依据,但仅靠声像图不能明确病变的组织学类型。彩色多普勒超声引导下穿刺活检术的应用可弥补这一不足,所有病例穿刺活检后均无严重并发症发生。初步研究结果提示,彩色多普勒超声结合超声引导下穿刺活检对乳腺癌肝转移的诊断、分期、治疗及预后的估测有重要的作用,且具有快速、安全、有效的特点。

The objective of this study was to assess the clinical significance of color Doppler sonographic characteristics and ultrasound-guided needle biopsy（USGB）on confirmation of diagnosis of breast cancer with liver metastasis（BCLM）.One hundred and five patients suspected to be suffering from breast cancer with liver metastasis were examined with color Doppler sonography and USGB,and the results were then analyzed and evaluated.The sonographic features of BCLM were solid nodules or tumor.Most of them were hypoechoic（86.7%,91/105）.Most tumors less than 3 cm showed regular shape,well-defined margins and even echoes.On the other hand,most tumors more than 3 cm showed irregular shape,indistinct margins and uneven echoes.The intensity of vascular signals was not taken as significant.Ultrasonography demonstrated the liver metastasis of breast cancer patients and USGB provided histological types.There were no serious complications in all cases after biopsy.In conclusion,ultrasonography and USGB are helpful for diagnosis and clinical stage divisions,especially in the evaluation of therapeutic effects with BCLM.They should be considered as a fast,effective and safe method in the diagnosis of BCLM.