乳腺叶状肿瘤的常规超声及超声弹性成像特点

Ultrasonography and ultrasonic elastography features of phyllodes tumors of the breast

目的观察乳腺叶状肿瘤(PTB)的常规超声及超声弹性成像(UE)的特点。方法回顾性分析26例经病理证实的PTB患者共30个病灶的常规超声及UE资料。结果 30个病灶中,位于外上象限19个,单发23个,呈分叶状11个,呈椭圆形11个,平行生长29个,病灶边界不清22个,内部为低回声病灶19个;所有病灶内部回声不均匀,后方回声增强病灶23个,伴有侧方声影23个,有包膜13个,有高回声间隔12个,无回声区6个;弹性评分平均(2.2±1.4)分,其中良性病灶(1.8±1.3)分,交界性病灶(3.0±1.2)分,恶性病灶4.0分。结论 PTB多位于外上象限,单发多见,形状以分叶状、椭圆形为主,平行生长,超声表现多为界限不清、内部呈不均匀低回声、伴有后方回声增强及侧方声影,部分可有包膜、有高回声间隔及无回声区;其弹性评分高于纤维腺瘤;恶性与交界性PTB硬度较良性高。

Objective To evaluate the ultrasonography and ultrasonic elastography features of phyllodes tumors of the breast （PTB）. Methods Ultrasonography and UE images of 30 PTB from 26 patients were retrospectively analyzed. Results Among 30 PTB, 19 located in upper outer quadrant of the breast, 23 occurred singly, 11 were lobulated and oval, 29 paralleled to the skin, 22 were poorly circumscribed, 19 were low echo-level of internal. The internal echo of all lesions were not homogeneous. Twenty-three lesions had posterior acoustic enhancement and lateral shadow, 13 had capsule, 12 had hyperechoic interval, while 6 had anoechoie areas. The mean elasticity score of all 30 PTB was 2.2q-1.4, while for be- nign ones was 1.8q-1.3, for borderline was 3.0：J： 1.2, for malignant was 4.0. Conclusion PTB presents as solid mass most occurring in upper outer quadrant of the breast with lobulated shape or oval, horizontal orientation with uncircumscribed margin, hypoechoic and nonhomogeneous internal echo, posterior acoustic enhancement and lateral shadow, some with capsule, hyperechoic interval and anoechoic areas. Elasticity score of PTB is higher than that of fibroadenoma. The hardness of borderline and malignant PTB are higher than those of benign PTB.