乳腺癌患者胸壁软组织结构异常区的超声检测

Ultrasonography of structurally abnormal soft tissue in chest wall of patients with breast cancer

目的探讨超声检出乳腺癌患者胸壁软组织结构异常的临床价值。方法对132例确诊为乳腺癌患者的胸壁进行超声扫查(范围为双侧腋中线及锁骨上区至肋弓),记录软组织结构异常情况,与病理穿刺结果对比分析。结果①本组软组织结构异常区转移癌患者109例,未转移患者23例,两组患者的超声特征在边界、内部回声、血流分级、后方声衰及淋巴结转移中比较差异有统计学意义(P﹤0.05),软组织异常区最大径比较差异无统计学意义;②超声检出软组织结构异常区转移癌患者102例,敏感性为88.9%,未转移患者30例,特异性为78.3%。结论超声对乳腺癌胸壁软组织结构异常区的检出率及诊断软组织转移的准确性均较高,结合超声引导下对异常区的穿刺活检能够快速、准确地做出诊断,为临床制定分期治疗方案提供依据。

Objective To investigate the value of uhrasonograhphy in the detection of structurally abnormal soft tissue in chest wall of patients with breast cancer.Methods The chest wall of 132 patients with breast cancer diagnosed by ultrasound was examined in detail by ultrasonograbphy.The scanning ranged from bilateral axillary midline and supraclavicular to rib bow.The ultrasonography findings of soft tissue were recorded , analyzed and compared with the pathology results.Results There were 109 cases of metastatic carcinoma and 23 cases without metastasis according to pathological diagnosis.Significant differences were found between these two groups in ultrasonography characteristics including the border,internal echo,flow classification,rear sound failure and lymph node metastasis（P 〈 0.05 ）, but not in the maximum diameter of the abnormal soft tissue area.According to the ultrasound diagnosis,there were 102 cases of metastatic carcinoma and 30 cases without metastasis.The sensitivity and specificity were 88.9% and 78.3% ,respectively.Conclusion The detection rate and diagnostic accuracy of ultrasonography are high for structurally abnormal soft tissue in chest wall of patients with breast cancer.In addition, ultrasound-guided biopsy in abnormal area can help make a quick and accurate diagnosis, which provide the basis for treatment at different stage.