高频彩色多普勒超声在诊断乳腺导管内乳头状瘤中的应用

Application of high frequency color Doppler ultrasound in diagnosis of breast intraductal papilloma

目的探讨高频多普勒超声对乳腺导管内乳头状瘤的诊断价值以及与其他相关疾病的鉴别诊断。方法回顾性分析经手术及病理证实的112例乳腺导管内乳头状瘤的高频多普勒超声的声像图特征,并对其误诊病例的声像图特征、误诊原因进行分析。结果 112例乳腺导管内乳头状瘤,有1例超声提示无异常发现,其余111例根据声像图特征分为5种类型。Ⅰ型:30例导管扩张伴导管内实性结节,6例可探及点状血流信号;Ⅱ型:11例囊实性混合团块,7例实性区域内可探及点线状血流信号,且有4例可探及高阻动脉频谱,5例发现散在点状钙化灶;Ⅲ型:20例单纯导管扩张,扩张的导管内未有异常的发现;Ⅳ型:27例导管扩张伴远端中断处实性团块,6例可探及点状血流信号,其中1例发现散在的点状钙化灶;Ⅴ型:23例实性团块而无导管扩张,7例可探及点状、线状血流信号,4例探及高阻动脉频谱。结论高频彩色多普勒超声在发现和诊断乳腺导管内乳头状瘤中具有较高的价值,是一种较为敏感的检查方法,可根据病灶的不同声像图表现、位置以及与导管的关系,并结合临床表现,综合做出诊断。

Objective To explore the value of high frequency color Doppler ultrasound in diagnosis of breast intraductal papilloma （BIDP） and differential diagnosiss of other correlated diseases. Methods The sonographic characteristics of 112 patients with BIDP confirmed by surgery and pathology were analyzed retrospectively, then the sonographic characteristics and causes of missed cases were analyzed. Results In 112 cases of BIDP, no abnormality was found in 1 case by ultrasound, then the rest 111 cases were divided into 5 types. Typy I included 30 cases of ductal ectasia with intraductal solid nodes, punctiform blood flow signals were detected in 6 cases ; type II included 11 cases of cystic - solid mixed masses, punctiform blood flow signals were detected in 7 cases of solid masses, and high resistance arterial spectra was detected in 4 cases, while punctifonn calcification lesions were found in 5 cases; type Ⅲ included 20 cases of simple ductal ectasia, no abnormality was found in ductus; type IV included 27 cases of ductal ectasia with solid nodes in distal end, punctiform blood flow signals were detected in 6 cases, and punctiform calcification lesions were found in 1 case; type V included 23 cases of solid nodes without ductal ectasia, punctiform blood flow signals were detected in 7 cases, high resistance arterial spectra was detected in 4 cases. Conclusion High frequency color Doppler ultrasound has high value in diagnosis of BIDP, it is an accurate and sensitive method. Combined with other clinical manifestion, it can improve the diagnostic rate.