乳腺肿块的高频彩超诊断与病理对照分析

High frequency ultrasonographic diagnosis of breast tumors:a comparison with pathology

目的探讨高频彩超在鉴别乳腺良、恶性肿块中的价值。方法对经病理证实的乳腺良、恶性肿块86例的高频彩超进行回顾性分析。结果高频彩超检查乳腺肿块86例,良性61例,超声检出57例,恶性肿块25例,超声检出23例。以RI=0.7为标准,诊断乳腺癌的敏感性0.92,特异性0.966,准确性0.930。彩色多普勒的阻力指数(RI)、脉动指数(PI)在良、恶性肿块中均有统计学差异(P<0.01)。彩超根据肿块彩色血流丰富程度分4级,良性肿块0、Ⅰ级为主,恶性肿块Ⅱ、Ⅲ级为主,二者有统计学差异(P<0.01)。结论高频彩超对乳腺性肿块的检出率高,应用二维声像图特点与彩色多普勒分析,综合判断,可明显提高对乳腺良、恶性肿块的诊断水平。

Objective To evaluate high resolution color Doppler uhrasonography in the differential diagnosis between benign and malignant breast tumors. Method The features of HFUS were retrospectively analyzed in 61 cases with breast benign tumors and 25 cases with malignant tumors identified by pathology. Results Eighty - six breast tumors were examined using high resolution color Doppler ultrasonography. Of the 61 benign tumors, 57 were detected by ultrasonography. Of the 25 malignant tumors, 23 were detected by ultrasonography. Resistance index （RI） and pulsation index （PI） were statistically different between benign and malignant breast tumors （ P 〈 0.01 ）. Taking RI = 0.7 as the standard, the sensibility was 0.92,the specificity 0. 966 and accuracy was 0. 930 in malig- nant breast tumors. Color Doppler flow imaging was divided into 4 levels according to the richness of blood vessels in breast tumors. Doppler flow imaging grades were 0 - I in most benign tumors, and II -III in most malignant tumors. The difference was significant. Conclusions The detection rate of HFUS is high. Using 2D and CDFI and PW quantitative analysis, an integrated examination may improve the diagnosis and differential diagnosis of breast tumors.