彩色多普勒超声诊断乳腺增生症的临床研究

Clinical research of diagnosis of cyclomastopathy by color Doppler ultrasonography

目的研究乳腺增生症的高频超声表现及与病理组织类型的关系,探讨高频超声对乳腺增生症的诊断价值。方法分析彩超诊断的440例乳腺增生症的声像图表现,并与病理和临床诊断对照。结果本组440例乳腺增生症根据病理类型和结果分为5类:乳腺小叶增生233例,乳腺纤维腺瘤样增生32例,乳腺囊性增生78例,乳腺组织增生67例,乳腺混合性增生30例。相对应的乳腺小叶增生主要超声表现为腺体粗糙不均形成低回声斑块;纤维腺瘤样增生主要表现为腺体组织内出现略欠规则的减低回声结节和包块,其周边区的乳腺结构无明显变化;乳腺囊性增生表现为腺体内不规则的导管扩张及清晰光滑的囊性占位;乳腺组织增生表现为腺体结构不清,密集增厚,弥漫性回声增强或减低,内无包块、结节或斑块,乳腺导管无扩张;乳腺混合增生主要表现为乳腺结构混杂不清,腺体粗大,内出现囊、实性病灶或导管扩张等。结论乳腺增生症超声表现与其病理结构改变相关。以乳腺增生症的超声图像表现结合病理类型诊断乳腺增生,对完善和规范乳腺增生症的超声诊断提供比较客观诊断依据和信息,可对超声和临床鉴别其他乳腺疾病提供一定的理论指导,为临床诊断乳腺增生提供了较好的帮助。

Objective To study the relationship between the high frequency ultrasonographic images of cyclomastopathy and its pathologic types,and to explore the value of high frequency ultrasonography（HFU） in the diagnosis of this disease.Methods HFU images of 440 case of cyclomastopathy were analyzed and compared with the pathologic and clinical diagnosis.Results According to pathologic findings,440 cases of cyclomastopathy were divided into five types：lobules hyperplasia of mammary gland in 233 cases,fibrosing adenosis hyperplasia of mammary gland in 32 cases,cystic hyperplasia of mammary gland in 78 cases,mammary glandular tissue hyperplasia in 67 cases and mixed hyperplasia of mammary gland in 30 cases.Accordingly,HFU images of lobules hyperplasia of mammary gland showed that the coarse and uneven glandular organs formed low echo-level plaques.HFU images of fibrosing adenosis hyperplasia showed slightly irregular nodules and lumps with reduced echo-level and surrounding mammary glandular tissues had no apparent structural changes.HFU images of cystic hyperplasia of mammary gland showed irregular ductal ectasia,and clear and smooth cystic space-occupying lesions.HFU images of mammary glandular tissue hyperplasia showed that the glandular organs were crowded and thickening with unclear structures and enhanced or reduced echo-level;no lumps/nodules/plaques were found in them and ductal ectasia didn＇t occurred.HFU images of mixed hyperplasia of mammary gland showed that the mammary glands became enlarged with mingled and unclear structures;cystic and solid lesions or ductal estasia were seen in them.Conclusion HFU images of cyclomastopathy appear to be related to its pathologic changes.The diagnosis of cyclomastopathy by HFU based on its pathological types can improve and standardize its ultrasonographic criteria.Therefore,HFU is helpful for the identification and diagnosis of the cyclomastopathy.