超声多参数在小体积乳腺叶状肿瘤良、恶性诊断中的价值

Ultrasonic Parameters Value in the Small Breast Phyllodes Tumor Diagnosis of Benign and Malignant

目的探讨超声多参数在小体积(直径<5cm)乳腺叶状肿瘤(PTB)良、恶性诊断中的价值。方法回顾性分析经手术病理证实的18例直径<5cm的PTB的超声表现。结果 18例PTB中,10例为良性,4例为交界性,4例为恶性。二维超声显示,肿瘤包膜是否完整、局部边缘有无浸润性回声、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良性与交界性、恶性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小体积乳腺叶状肿瘤良性与交界性、恶性之间的差异具有统计学意义(P<0.05);小体积良性叶状肿瘤的血流分级多为0级、I级,交界性、恶性叶状肿瘤的血流分级多为II级、III级;交界性、恶性叶状肿瘤的峰值流速(Vmax)在乳腺叶状肿瘤良性与交界性、恶性之间的差异具有统计学意义(P<0.05)。结论小体积乳腺恶性叶状肿瘤超声声像图上具有特征性表现,对包膜不完整,局部边缘有浸润性回声、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(RI)增高及峰值流速(Vmax)增快者应考虑乳腺恶性叶状肿瘤的可能,但高频超声多参数对小体积叶状肿瘤恶性与交界性的鉴别诊断仍需进一步研究。

Objective To explore the ultrasound parameters in small size （diameter〈 5cm）of breast phyllodes tumor （PTB）of benign, malignant diagnosis value. Methods Retrospective analysis was proved by operation and pathology in 18 cases with diameter less than 5cm PTB ultrasound. Results 18 cases of PTB, 10 cases were benign, 4 borderline cases, 4 cases were malignant. Two dimensional ultrasound display, tumor capsule is complete, the local edge without invasive echo, echo is homogeneous, the presence of cystic degeneration, posterior echo attenuation or not in phyllodes tumors of the breast benign and borderline between malignant, the difference was statistically significant （P 〈 0.05） ; color Doppler flow classification in a small volume of breast phyllodes tumor benign and borderline between malignant, the difference was statistically significant （P 〈 0.05）; small size benign phyllodes tumor blood flow grading for the class 0, grade I; borderline, malignant phyllodes tumor Peak flow velocity （Vmax）in breast phyllodes tumor benign and borderline between malignant, the difference was statistically significant （P 〈 0.05）. Conclusion Small breast malignant phyllodes tumor of the ultrasonographic features of coating performance, incomplete, local edge invasive echo, inhomogeneous echo, cystic masses, rear echo attenuation and tumor in abundant blood flow, arterial resistance index （RI） increased and peak velocity （Vmax） increases quickly breast malignant phyllodes tumor should be considered possible, but the high frequency ultrasound parameters on the small breast phyllodes tumors in the differential diagnosis of malignant and borderline still need to be further studied.