高频超声综合参数在乳腺叶状肿瘤与纤维腺瘤鉴别诊断中的价值

Value of High Frequency Ultrasound Parameters in Differential Diagnosis of Breast Phyllodes Tumor and Breast Fibroadenoma

目的探讨高频彩色多普勒超声多参数综合分析在乳腺叶状肿瘤与纤维腺瘤鉴别诊断中的价值.方法对经术前超声检查及手术治疗并经病理证实的30例乳腺叶状肿瘤及120例纤维腺瘤患者的病例资料进行回顾性分析(病理结果为诊断金标准).结果乳腺叶状肿瘤患者的年龄大于乳腺纤维腺瘤患者,两者相比差异具有统计学意义(P<0.05);二维超声显示,肿瘤形状、包膜是否完整、内部回声是否均匀、是否存在囊性变、后方回声是否衰减在乳腺叶状肿瘤与纤维腺瘤之间的差异具有统计学意义(P<0.05);彩色多普勒血流分级在乳腺叶状肿瘤与纤维腺瘤之间的差异具有统计学意义(P<0.05),脉冲多普勒动脉阻力指数(R)I及收缩期峰值流速(Vmax)在乳腺叶状肿瘤与纤维腺瘤之间的差异具有统计学意义(P<0.05).结论乳腺叶状肿瘤和纤维腺瘤在超声声像图上具有特征性表现,对年龄较大、肿块分叶状、包膜不完整、内部回声不均匀、有囊性变、肿物后方回声衰减及肿物内血流丰富、动脉阻力指数(R)I增高及峰值流速(Vmax)增快者应考虑乳腺叶状肿瘤的可能,但高频超声多参数对于叶状肿瘤的良性与恶性的鉴别诊断仍需进一步研究.

Objective To investigate the value of multiple parameters of high frequency color Doppler ultrasound in differential diagnosis of breast phyllodes tumor and breast fibroadenoma.Methods We retrospectively analyzed the data of 30 cases of breast phyllodes tumor and 120 cases of fibroadenoma patients who received preoperative ultrasound examination and postoperative pathology confirm（histopathological findings as a gold standard for diagnosis）.Results Patients with breast phyllodes tumor were older than those with breast fibroadenoma,and the difference was statistically significant（P〈0.05）.Two-dimensional ultrasound showed there were statistically significant differences in tumor shape,capsular integrality,internal echo homogenety,the presence of cystic degeneration,posterior echo attenuation between breast phyllodes tumor and breast fibroadenoma（P〈0.05）.Color Doppler flow grading showed statistically significant difference between breast phyllodes tumor and breast fibroadenoma（P〈0.05）.Pulsed Doppler artery resistance index（RI）and peak systolic velocity（Vmax）had statistically significant difference between breast phyllodes tumor and breast fibroadenomae（P〈0.05）.Conclusions Breast phyllodes tumor and breast fibroadenoma have ultrasonographic features.For patients in older age,with lobular mass,incomplete envelope,uneven internal echo,cystic masses,rear echo attenuation and abundant blood flow in tumor,increase of arterial resistance index（RI）and peak velocity（Vmax,breast phyllodes tumor may be considered,but high frequency ultrasound parameters for the differential diagnosis of benign tumor and malignant tumor still needs further research.