高频彩色多普勒超声诊断小乳腺癌65例分析

Analysis on 65 cases with small breast cancer diagnosed by high-frequency color Doppler ultrasonography

目的:探讨高频彩色多普勒超声对小乳腺癌的诊断价值。方法:对经手术病理证实的65例小乳腺癌(直径<2cm)的高频二维声像图及彩色多普勒血流显像特点及血流参数阻力指数(RI)大小进行回顾性分析。结果:65例小乳腺癌(BI-RADS4级)均为单发,发生在乳腺外上象限30例(46.15%),内上象限8例(12.30%),外下象限9例(13.85%),乳晕区15例(23.08%),内下象限3例(4.62%)。病理类型:单纯癌28例,浸润性导管癌23例,髓样癌7例,腺癌5例,小叶癌2例。65例小乳腺癌高频二维声像图特征为低回声团块,多数境界清楚,边缘欠光整,无明显包膜,少数呈"蟹足样"改变。团块纵径大于横径,纵径/横径之比>1,内部回声均匀,有"点状"或"针尖样"光斑,声影不明显,彩色多普勒显示团块内部及周边"短线状"血流信号,呈动脉频谱,阻力指数RI>0.75。结论:高频彩色多普勒超声能够准确地反映乳腺肿块的特征表现,是鉴别乳腺肿块性质的重要检查方法。

Objective： To explore the value of high - frequency color Doppler ultrasonography in diagnosis of small breast cancer. Methods： The high - frequency two - dimensional sonography, imaging characteristics of color Doppler flow and resistance index （RI） of 65 cases with small breast cancer confirmed by pathological examination were analyzed retrospectively. Results： The small breast cancer （diameter 〈2 cm） was solitary among 65 cases, the distributions of small breast cancer included upper outer quadrant （30 cases, 46. 15% ） , upper inner quadrant （8 cases, 12. 30% ） , lower outer quadrant （9 cases, 13.85% ） , areola area （ 15 cases, 23.08% ） and lower inner quadrant （3 cases, 4. 62% ） . Pathological types： 28 cases of simplex carcinoma, 23 cases of infiltrating duetal carcinoma, 7 cases of medullary carcinoma, 5 cases of adenoearcinoma, 2 cases of lobular carcinoma. The imaging characteristics of high - frequency two - dimensional sonography were hypoeehoic lumps, and most of them had clear boundary, rough edge, without obvious capsule, some of them showed crab - like changes. Longitudinal diameter of lumps was longer than transverse dihmeter, longitudinal/transverse diameter 〉 1, inter- nal echo was homogeneous, with spot - like or point - like light spot and unconspicuous sound shadow, color Doppler uhrasonography showed that intratumoral and peritumoral blood flow signals were short -linear, showingarterial spectrum, RI 〉 0. 75. Conclusion： High -frequency color Doppler ultrasonography can reflect the characteristics of breast lumps precisely, which is an important method to differentiate the character of breast lumps.